How Will Indolent Lymphoma/B-Cell NHL Care Be Improved in the Future?
There will be an unmet need for therapy in patients with aggressive lymphomas who did not benefit from therapy with bispecifics, CAR-T, chemotherapy, and targeted therapy.
According to Lorenzo Falchi, MD, an oncologist and hematologist specializing in lymphoma at the Memorial Sloan Kettering Cancer Center, the bar for indolent lymphoma and B-cell non-Hodgkin lymphoma care has risen a great deal over the past decade.
CancerNetwork® spoke with Falchi at the Society of Hematological Oncology (SOHO) 2025 Annual Meeting after he delivered a presentation titled “Novel Immunotherapy Combinations in Indolent Lymphoma”.
Falchi compared the landscape for these disease types with what has been observed in Hodgkin lymphoma; eventually, they will need to shift the conversation to consider de-escalating and optimizing therapy.
In the wake of these developments and improvements, there will also be an unmet need for the patients who don’t benefit from these therapies, as they will, most likely, already have exposure to bispecifics and CAR-T, as well as chemotherapy and targeted therapy.
Transcript:
We’ve raised the bar a lot, and improving upon that will not just come with new treatments that are going to be better than the last. Much like it’s happened in a space like Hodgkin lymphoma, where the bar is so high they are starting to think about de-escalating therapy or optimizing therapy, we’re going to be thinking along similar lines in B-cell non-Hodgkin lymphoma. This is [also] true for aggressive lymphoma, where the addition of bispecifics to chemotherapy in the frontline setting has the potential to increase cure rates, and where CAR T-cell therapy has a very large potential in the second line space; the number of patients with recurrent disease will be smaller and smaller. The same is true for follicular, marginal zone, and other indolent lymphomas, where we have these very powerful treatments that induce deep responses, and the benefit can last…several years, each time. The arc of the patient is going to be very long.
But the unmet need that comes with both in both the aggressive and indolent lymphoma space, due to the improved therapeutic means, is that patients who don’t benefit, albeit less numerically than before, are going to present a whole new challenge to us because, obviously, we have no idea, biologically, what a disease is going to look like after having been exposed to a bispecific antibody, a CAR T-cell therapy, and maybe throw some chemotherapy, or maybe a targeted therapy, [in there].
What kind of resistance mechanisms are going to emerge, and how do you tackle them? There’s going to be a whole new, perhaps smaller, but more challenging population of patients that we’re going to have to serve. How to do that is going to have to be a mix of, yes, new technology and new treatment options, but also a lot of learning from the current treatment options and trying to maximize the learning from the patients who don’t do well with the current treatment strategies that we have available.
References
Falchi, L. Novel immunotherapy combinations in indolent lymphoma. Presented at the Society of Hematological Oncology 2025 Annual Meeting; September 2-6, 2025; Houston, TX.
