Is there a cure for follicular lymphoma?

Is there a cure for follicular lymphoma?
So this is a great question,
and you may get different answers
from different providers.
Historically,
the narrative that has been pushed around
is that follicular
lymphoma is not insurable,
though you may argue that this statement
is based on all literature
and to times
where only chemotherapy was available. I would say that currently
with the advent of novel agents,
including immunotherapy,
biological agents, targeted agents
by specific cellular therapy,
these are not they may be changing.
And in the community,
we're kind of divided.
Some of us believe
or maybe hope that with this new age
and with longer follow up,
we may see a fraction of patients
who will not relapse
and that we may consider cure.
But, of course, we need a lifetime
to make this determination,
when we see patients in clinic,
we see that a follicular inflammation,
incurable disease.
However, the
we see scores is very heterogeneous between patients.
Some patients can be observed lifelong
and they never required any therapy.
Those are basically patients
with low volume of disease
for the competition that you do the scans
and you you find as more lymph nodes,
many times
also with bone marrow involvement.
But patience is what we call
advanced stage no great low volume,
follicular lymphoma.
And many of those patients can be
usually we observed many of them
they never acquired in therapy,
contrary patients with a larger,
more disease burden, they usually receive
a different line of chemotherapy.
So some the most commonly
the United States has been the Mustang,
single rituximab
or R-CHOP in some specific cases.
And also some patients.
respond well to these treatment
and they're able to achieve long term
remissions, long term responses.
However, most of the
patients relapse median alternating cycles
of treatment with period of observation
So it's a great question.
I think we're getting closer to more cures
in, you know, in patients that have what
we call more advanced stage disease.
And we'll probably talk about that later.
We generally think that Flicka lymphoma
is something that at some point
is going to come back,
you know, in some way.
The kind of flipside of that,
as many cases of looking
lymphoma actually don't really need
any treatment at all and can be observed
for for years and sometimes decades
without really causing a problem in the
you know, with the patient
in terms of symptoms or or function
of their organs inside or their longevity.
There are a couple of particular scenarios
where I think Follicular lymphoma,
we think about cure is one
is of a diagnosis that's very localized.
So one lymph node group
that we can successfully do things
like surgery and radiation.
I think many of those cases
we do aim for a cure
and probably more than half of them
we are successful with that.
I think
excitingly, there's a number of new
but very potent immunotherapies
that probably offer the promise of cure
just in terms of the way
these therapies work.
And, you know,
that is different from chemotherapy
and the experience with other diseases.
I think it remains to be seen
what percentage of patients are cured
for follicular lymphoma.
But again, traditionally,
we think it's something that a patient's
going to have to be followed for for,
you know, for all
for the rest of their life,
but not necessarily something that
at any given time is is going to cause
major problems with their health.
And many of these patients can live
a very long and happy and productive life
with follicular lymphoma
It depends on the overall stage.
In some cases,
if you have advanced follicular lymphoma,
it's not considered a terrible disease,
but it can still be very treatable.
So even though the disease doesn't go away
completely,
many patients can live for decades
with follicular lymphoma after treatment
in the early stage setting, if it's what
we call a stage one or stage two,
if it's all in one area,
we do consider those lymphomas
potentially treatable, but we would
incorporate different types of treatment.
For example,
sometimes we incorporate radiation
for that treatment
to try and cure the disease.