Sarah Rutherford, MD, Talks Recent Advances, Priorities to Pursue in Follicular Lymphoma Management

Sarah Rutherford, MD, is an associate professor of clinical medicine at Weill Cornell Medicine, New York. With Weill Cornell Medicine colleagues John Leonard, MD, and Erin Mulvey, MD, she has coauthored a review article published in Blood on the current state and projected future of follicular lymphoma (FL) management. She recently spoke with Blood Cancers Today on this subject.

Dr. Rutherford described how currently for many patients, frontline FL treatment primarily involves chemotherapy and anti-CD20 monoclonal antibodies, which carry toxicity concerns. However, clinical trials are underway to expand the frontline options for FL. Noteworthy among the approaches being investigated are bispecific antibodies, which are already FDA-approved in the third-line setting and are now being assessed for use in earlier lines of therapy and polytherapy.

“We think that it is likely that that may replace chemotherapy-based treatment for patients in their first line of treatment in the future,” Dr. Rutherford said.

Regarding priorities that clinicians should pursue when managing FL, Dr. Rutherford stressed the importance of, as much as is currently possible, identifying and treating early any patients who have risk for early disease progression or conversion to aggressive lymphoma. Clinicians and clinical trials, such as those for bispecific antibodies, should also emphasize quality of life and patient-reported outcomes.

“I think that that’s really key for us to incorporate, especially with these novel therapies as we move forward, to really try to optimize them feeling as well as possible for as long as possible,” Dr. Rutherford explained.

Dr. Rutherford also expects that recent advances in disease monitoring and testing will be a boon for both management and clinical trials in FL. She finds circulating tumor DNA to be especially exciting and noted it will be very useful in making tolerability and continuation decisions as they evaluate newer therapies, such as bispecific antibodies.

“These type[s] of treatments do have an impact on the immune system. They make patients more susceptible to infection. So even though they are very well tolerated, we do want to try to minimize the treatment over time to try to make sure that people are feeling well and not getting sick and having infections,” Dr. Rutherford elaborated.

Given the rapid clinical advances in FL management in recent years, Dr. Rutherford’s outlook for patients with this disease is optimistic.

“We are so excited for our patients more than anything else because I think that they’re going to continue to do better, tolerate treatment better, live longer, and live better as we move forward in the future,” Dr. Ruthford summarized.

Reference

Mulvey E, Rutherford SC, Leonard JP. The future of follicular lymphoma management: Strategies on the horizon. Blood. Published online February 28, 2025. doi:10.1182/blood.2024026017