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Review
. 2023 May 3:13:1170394.
doi: 10.3389/fonc.2023.1170394. eCollection 2023.

Novel targeted drugs for follicular and marginal zone lymphoma: a comprehensive review

Andrea Rivero  1   2 , Pablo Mozas  1   2 , Laura Magnano  1   2 , Armando López-Guillermo  1   2   3
Affiliations
Review

Novel targeted drugs for follicular and marginal zone lymphoma: a comprehensive review

Andrea Rivero et al. Front Oncol. .

Abstract

Although mostly incurable, indolent non-Hodgkin lymphomas (iNHL) are chronic diseases with a median overall survival approaching 20 years. In recent years, important advances in the knowledge of the biology of these lymphomas have led to the development of new drugs, mostly chemotherapy-free, with promising outcomes. With a median age of around 70 years at diagnosis, many patients with iNHL suffer from comorbid conditions that may limit treatment options. Therefore, nowadays, in the transition towards personalized medicine, several challenges lie ahead, such as identifying predictive markers for the selection of treatment, the adequate sequencing of available therapies, and the management of new and accumulated toxicities. In this review, we include a perspective on recent therapeutic advances in follicular and marginal zone lymphoma. We describe emerging data on approved and emerging novel therapies, such as targeted therapies (PI3K inhibitors, BTK inhibitors, EZH2 inhibitors), monoclonal antibodies and antibody-drug conjugates. Finally, we describe immune-directed approaches such as combinations with lenalidomide or the even more innovative bispecific T-cell engagers and chimeric antigen receptor T-cell therapy, which can achieve a high rate of durable responses with manageable toxicities, further obviating the need for chemotherapy.

Keywords: CAR-T cells; follicular lymphoma; immunotherapy; marginal zone lymphoma; targeted therapy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Overview of novel targeted drugs for follicular and marginal zone lymphoma, depicting their mechanisms of action.
Figure 2
Figure 2
Partial response (light green) and complete response rates (dark green) in trials evaluating small molecules with targeted action for FL/MZL patients having received at least 2 prior lines of therapy. FL, follicular lymphoma; MZL, marginal zone lymphoma; R, rituximab; mut, mutated; WT, wild type.
Figure 3
Figure 3
Partial response (light orange) and complete response rates (dark orange) in trials evaluating immune-directed therapies for FL/MZL patients having received at least 2 prior lines of therapy. FL, follicular lymphoma; MZL, marginal zone lymphoma; R, rituximab; O, obinutuzumab.
See this image and copyright information in PMC

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