Physician Assistant Perspectives: Aligning Patient Goals in R/R FL and Navigating Third-Line Treatment Options

EP: 1.Overview of R/R FL: Focus on the 3rd-Line Setting and Beyond START

EP: 2.Managing 3rd-Line R/R FL: Recognizing Progression, Performing Rebiopsies, and Rechecking for CD20 Positivity

EP: 3.Aligning Treatment Goals in R/R FL: Physician vs Patient Perspectives

EP: 4.Clinical Scenario: A 73-Year-Old Patient With R/R FL Requires Treatment in the Third-Line Setting

EP: 5.Expert Perspectives: Tazemetostat in R/R FL

EP: 6.Choosing Between Tazemetostat and Zanubrutinib+Obinutuzumab: Key Factors & Patient Conversations

EP: 7.Assessing CAR T and Bispecifics for R/R FL: Identifying the Right Candidates & Factoring in CD20 and CD19 Negativity or Positivity

EP: 8.Navigating Treatment Choices in R/R FL: Patient Values and Shared Decision-Making

EP: 9.Managing R/R FL: Evolving Sequencing Strategies

EP: 10.Key Strategies and Perspectives: How Novel 2nd-Line Therapy Options May Impact 3rd-Line Treatment Landscape in R/R FL and Bridging Strategies to CAR T

EP: 11.Collaborating With Community Providers in Treating Patients With Complex R/R FL

EP: 12.Looking Ahead in R/R FL: Unmet Needs and What’s Next

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EP: 13.Physician Assistant Perspectives: Aligning Patient Goals in R/R FL and Navigating Third-Line Treatment Options

EP: 14.Physician Assistant Perspectives: Importance of Patient Shared Decision-Making and Multidisciplinary Team Approach in R/R FL

EP: 15.Physician Assistant Perspectives: When to Consider Tazemetostat in R/R FL

When treating patients with follicular lymphoma in the relapsed setting, one of the main considerations is how many prior lines of treatment the patient has already undergone. The ultimate goal often differs between patients and providers. While many patients hope for remission or a cure, follicular lymphoma is generally not curable, so achieving remission or controlling disease progression becomes the primary objective. Especially in later lines of therapy, the focus may shift from aggressive attempts to eliminate disease to simply stabilizing it and preventing further progression, as some treatments may take longer to work or carry greater risks compared to earlier, more aggressive therapies.

In the third-line treatment setting, there are multiple options available, including CAR T-cell therapies, bispecific antibodies, and oral regimens like tazemetostat or zanubrutinib combined with obinutuzumab. The challenge lies in selecting the most appropriate therapy based on the individual patient's characteristics. Factors such as age, treatment accessibility, financial burden, and preferences about treatment duration are key considerations. Some patients prefer a defined course of treatment that is intense but limited in duration, while others may opt for ongoing oral therapy that offers convenience but requires long-term commitment and monitoring.

The decision-making process involves educating patients about the benefits and drawbacks of each option. CAR T-cell therapy, for example, often requires hospitalization and frequent clinic visits, with potential for significant toxicity. Bispecific antibodies also involve an initial period of frequent dosing before transitioning to less frequent visits. Oral therapies can be convenient but may pose financial challenges, especially for those on Medicare. By incorporating patients’ lifestyles and preferences into the conversation, providers can help tailor treatment plans that balance efficacy, safety, and quality of life in this complex setting.