Topline Presentation Points 
Follicular Lymphoma (1:23 -10:35)

Update to ESMO/EHA therapeutic algorithm

For high tumour burden consider antibody maintenance (or radioimmunotherapy)
Dreyling, Ann Oncol 2021


FOLL12 Study
Response adapted post-induction strategy in patients with advanced-stage follicular lymphoma (Luminari, ASH 2021)

  • High Tumour Burden, no previous treatment
  • Comparing Induction therapy 6x R-CHOP+2R vs 6x R-Benda+2R

Key takeaways:

  • PFS similar
  • Differences in toxicity
    • Less alopecia (a patient preference)
    • Higher Infection and skin SAE with BR vs R-CHOP
    • Post induction – higher neutropenia with BR

First relapse/progression

ESMO/EHA therapeutic algorithm, (Dreyling, Ann Oncol 2021)

MAGNIFY Study (Lansigan F, et al. ASH 2021)
Phase 3b Study of Lenalidomide + Rituximab (R2) Followed by Maintenance

  • Building on current ESMO/EHA algorithm this study compares RL induction followed by maintenance or RL or R

Key takeaways:

  • R2 is active with a tolerable safety profile
  • Median PFS (95% CI)


Immunotherapy has a place for rrFL high risk patients

Phase I/II GO29781 study (Morschhauser, ASH 2021)

  • mosunetuzumab+ lenolidomide

Key Takeaways:

  • induces high and durable complete response rates in people with follicular lymphoma who have received two or more prior therapies
  • 90% ORR.

ZUMA-5: Long-Term Follow-up Analysis of Axi-cel, (Neelapu et al. ASH 2021)

  • Very high-risk R/R FL patients
  • median > 3 prior treatments
  • POD 24 in the majority from first anti-CD20 mAb- containing therapy

Key Takeaways:

  • ORR 94%
  • CR 79%
  • 1 time treatment long term PFS is holding up after 36 months
  • Median OS was not yet fully reached in the efficacy-eligible patients

Current GLA (German Lymphoma Alliance) studies in 2022
R2+/- Tazemetostat
R2+/- Tafasitamab
R2 vs Mosunetuzumab


Mantle Cell (10.35 –24:35)

Standard of Care [update from EU]

1st line for Younger Patients (<65)
Current EU approach: Dose intensified immune-chemotherapy (R-CHOP, high dose Ara-C) -> aSCT -> R maintenance

Update: Substitute 3 cycles of R-CHOP with 3 cycles of R-DHAP, (an update by Hermine, et al. ASH 2021)

Key Takeaway:

  • Median TTF : R-DHAP 8.4 years R-CHOP 3.9 years
  • 10-year TTF (95% CI): R-DHAP 46% (39% – 54%) R-CHOP 25% (19% – 32%)
  • 10 year OS also improved with R-DHAP vs R-CHOP

1st line for Elderly Patients (>65)
Role of Rituxan (R) maintenance after first-line BR or R-CHOP, (Salles, EHA 2021)

Key Takeaway:

  • Maintenance improves PFS after R-CHOP and BR and translates into significant benefit in OS

1st relapse
Which patients will benefit from targeted approaches?

Ibrutinib in relapsed MCL (POD 24), Visco, Leukemia 2021

  • Ibrut vs R-B or R-BAC
  • Young fit patients

Key Takeaways:

  • Ibrut beneficial for patients who relapse within 2 years with significant O/S benefit
  • Late POD no difference
  • Based on results Ibrut is strongly pushing into first-line

MCL-R2 Elderly, (Ribrag et al. ASH 2021)

Rituximab-Lenalidomide(R2) after first Line Immunochemotherapy

Key Takeaways:

  • R2 Maintenance is superior to R maintenance for PFS but not OS.
  • Safety data showed more toxicity in the R2M arm.

Emerging Treatments /Other ongoing trials

Front-line for Elderly Patients
Phase III SHINE and ENRICH Trials

  • Comparing Ibrut to progression with BR-> R maintenance vs BR -> R maintenance
  • ·s Chemo-free as good as CIT?


  • Comparing Ibrut vs Ven with BR-> R maintenance
  • Best chemo free combo? Is cessation possible?


  • 3xR-CHOP+ I -> I+R maintenance vs 3xR-CHOP+ I -> ASCT+R maintenance

Failure after Ibrutinib
CAR -T Brexu-Cel – Real World Experience from the US Lymphoma CAR T Consortium (Wang et al ASH 2021)

Key Takeaways

  • High-risk patient population with 82% prior BTKi and 35% Ven
  • Day 30 ORR of 88% (66% CR and 22% PR).
  • Best ORR comparable to ZUMA-2 trial of 93%

BiTEs – Glofitamab (Philips, ASH 2021)

Key Takeaways:

  • Glofitamab in combo with obintuzumab
  • Majority pretreated with BTKi and almost 90% refractory
  • ORR: 81% and CMR: 67

Irreversible non-covalent BTKi – Phase I/II BRUIN Study (Wang, ASH 2021)

Key Takeaways:

  • Pirtobrutinib, LOXO-305
  • Duration of Response in Mantle Cell Lymphoma
    • Median follow-up of 8.2 months (range, 1.0 – 27.9 months) for responding patients
    • 60% (36 of 60) of responses are ongoing