Service d'Hematologie, Institut Universitaire du Cancer de Toulouse-Oncopole, Center for Cancer Research of Toulouse (CRCT), Inserm UMR1037, IUC-Toulouse-Oncopole, 1 Avenue Irene Joliot-Curie, Toulouse 31059, France.
Univ. Lille, CHU Lille, ULR 7365 - GRITA - Groupe de Recherche Sur les Formes Injectables et les Technologies Associees, Lille F-59000, France.
Hematol Oncol Clin North Am. 2020 Aug;34(4):715-726. doi: 10.1016/j.hoc.2020.02.007. Epub 2020 Apr 8.
New treatment strategies in follicular lymphoma (FL) are driven by a deeper understanding of microenvironmental cues supporting lymphomagenesis, chemoresistance, and immuno-escape. These immune-mediated signaling pathways contribute to initial learnings and clinical successes with lenalidomide, the first, oral, non-chemotherapeutic immunomodulatory drug, combined with anti-CD20 antibodies. This combination of lenalidomide with rituximab showed similar efficacy to chemoimmunotherapy (CIT) in first-line patients requiring therapy, and is approved in relapsed/refractory FL. We review the biology supporting the rationale for adequate inhibitory receptor/ligand pathways targeting the tissue immune microenvironment of FL cells, and potential immunomodulating combinations to replace CIT in the near future.
滤泡性淋巴瘤（FL）的新治疗策略是基于对支持淋巴瘤发生、化疗耐药和免疫逃逸的微环境线索的更深入了解。这些免疫介导的信号通路为来那度胺的初步研究和临床成功做出了贡献，来那度胺是第一个口服、非化疗免疫调节药物，与抗 CD20 抗体联合使用。来那度胺与利妥昔单抗联合应用在需要治疗的一线患者中的疗效与化疗免疫治疗（CIT）相似，并且已在复发性/难治性 FL 中获得批准。我们回顾了支持针对 FL 细胞组织免疫微环境的充分抑制性受体/配体通路的生物学基础，以及在不久的将来替代 CIT 的潜在免疫调节联合用药。
