Services of Pathology and Haematology, Fundación Jimenez Diaz , Madrid, Spain.
Expert Rev Hematol. 2020 Dec;13(12):1361-1372. doi: 10.1080/17474086.2020.1850252. Epub 2020 Dec 4.
: Follicular lymphoma (FL) is one of the most common non-Hodgkin lymphoma (NHL) types, where genomic studies have accumulated potentially useful information about frequently mutated genes and deregulated pathways, which has allowed to a better understanding of the molecular pathogenesis of this tumor and the complex interrelationship between the tumoral cells and the stroma. : The results of the molecular studies performed on Follicular Lymphoma have been here reviewed, summarizing the results of the clinical trials so far developed on this basis and discussing the reasons for the successes and failures. Searches were performed on June 1, 2020, in PubMed and ClinicalTrials.gov. : Targeted therapy for follicular lymphoma has multiple opportunities including the use of epigenetic drugs, PI3K inhibitors, modifiers of the immune stroma and others. Data currently known on FL pathogenesis suggest that combining these treatments with immunotherapy should be explored in clinical trials, mainly for patients with clinical progression or adverse prognostic markers. Association of targeted trials with dynamic molecular studies of the tumor and serum samples is advised. Chemotherapy-free approaches should also be explored as first-line therapy for FL patients.
滤泡性淋巴瘤（FL）是最常见的非霍奇金淋巴瘤（NHL）类型之一，其基因组研究积累了有关经常发生突变的基因和失调途径的潜在有用信息，从而使人们能够更好地了解该肿瘤的分子发病机制以及肿瘤细胞与基质之间的复杂相互关系。在这里，我们回顾了对滤泡性淋巴瘤进行的分子研究结果，总结了迄今为止在此基础上开展的临床试验的结果，并讨论了成功和失败的原因。搜索于 2020 年 6 月 1 日在 PubMed 和 ClinicalTrials.gov 上进行。滤泡性淋巴瘤的靶向治疗有多种机会，包括使用表观遗传药物、PI3K 抑制剂、免疫基质调节剂等。目前已知的 FL 发病机制数据表明，应在临床试验中探索将这些治疗方法与免疫疗法联合使用，主要针对有临床进展或预后不良标志物的患者。建议将靶向试验与肿瘤和血清样本的动态分子研究相结合。也应探索无化疗方法作为 FL 患者的一线治疗。
