Dr Ann LaCasce Looks to the Year Ahead in the Lymphoma Treatment Landscape

Ann LaCasce, MD, MMSc, director of the Dana-Farber/Mass General Brigham Fellowship in Hematology/Oncology and chair of the Lymphoma Research Foundation’s Scientific Advisory Board, discusses potential shifts in the lymphoma space in the year ahead. With novel therapies moving into earlier lines of therapy and additional potential approvals on the horizon, the future looks exciting in this dynamic space.

Transcript

Looking to the year ahead, what do you foresee shifting—or staying the same—in the lymphoma space?

Last year was a very exciting year. The last couple of years, we've seen CAR [chimeric antigen receptor] T come into second line, and now we're seeing the bispecifics, which I think are a real game changer, both looking at clinical trials in frontline indolent lymphomas like follicular lymphoma and hopefully marginal zone lymphoma. I think we'll see clinical trials, I think you'll see in clinical practice that we're going to be using these very frequently in relapsed and refractory patients. For aggressive lymphomas, for patients who have recurred after CAR T, I think, again, we'll be seeing bispecifics, they will be incorporated upfront. There are a number of trials ongoing to try to improve on polatuzumab–R-CHP [cyclophosphamide, doxorubicin, and prednisone], which has become a standard therapy for patients with aggressive lymphoma, so I think that is exciting. [In] mantle cell lymphoma, we have pirtobrutinib now in the third line—again, waiting for the bispecifics to be approved in that setting. There's some ongoing trials testing that against standard of care. In CLL [chronic lymphocytic leukemia], we have lots of options, and I think now the real challenge in that field is to define which patients benefit from which therapy. Should we be combining multiple agents and doing time-limited, MRD [minimal residual disease]–driven therapy, or should we sequence things? Because we know these patients typically live a very long time. So I think more of the same, but very exciting. More of the same in terms of bispecifics and these novel agents, and just really trying to define and move them forward.