Hear how a single ctDNA blood draw 3 to 9 weeks into immunotherapy may reveal response earlier than imaging in NSCLC, with Valsamo Anagnostou, MD, PhD.
|Videos|May 28, 2020
A 69-Year-Old Woman With Follicular Lymphoma
Author(s)Ajay K. Gopal, MD
Ajay K. Gopal, MD, discusses the rationale for treating a 69-year-old woman with high-risk follicular lymphoma with a PI3-kinase inhibitor in the third-line setting.
Advertisement
Case:A 69-Year-Old Woman With Follicular Lymphoma
Initial Presentation
- A 69-year-old woman complains of a 5-month history of fatigue, decreased appetite and a 10-bs. weight loss
- PMH: unremarkable
- PE: right axillary and bilateral cervical lymph nodes palpated ~ 3 cm; spleen palpable 4 cm below costal margin
Clinical Work-up
- Labs: ANC 1.6 x 109/L, WBC 11.8 x 109/L, 40% lymphocytes, Hb 8.9 g/dL, plt 98 x 109/L, LDH 308 U/L, B2M 3.7 µg/mL; HBV negative
- Excisional biopsy of the lymph node on IHC showed CD 20+, CD 10+, BCL2+; follicular lymphoma grade 2
- Bone marrow biopsy showed paratrabecular lymphoid aggregates, 45% involvement
- Molecular genetics: t(14;18) (q32;q21)
- PET/CT showed enlargement of right axillary lymph nodes (3.1 cm, 3.2 cm), diffusely enlarged nodes in the retroperitoneal and lumbar lymph nodes
- Ann Arbor Stage IV; ECOG 1
Treatment
- She was treated with R-CHOP for 6 cycles with rituximab maintenance; achieved partial response
- 5 months later she complained of increasing fatigue
- Repeat PET/CT revealed progression of disease
- She was started on bendamustine + obinutuzumab for 6 cycles and continued maintenance obinutuzumab
- Repeat lymph node biopsy remained grade 1-2 follicular lymphoma
- 9 months later she complained of chills and low-grade fever
- She was started on idelalisib 150 mg PO BID
Advertisement
Related to this article
Updated ENZARAD findings show no significant metastasis-free survival benefit with enzalutamide, although patients receiving pelvic lymph node radiation may benefit from intensification.
Short-course neoadjuvant botensilimab plus balstilimab drives deep responses in resectable pMMR and dMMR colon cancer, with ctDNA clearance and no recurrences.
The FDA granted final approval to Alembic's generic venetoclax tablets, rated therapeutically equivalent to Venclexta, for CLL/SLL and newly diagnosed AML.
Lauren Banks, MD, PhD, explains early findings from a pilot study of lifileucel in dedifferentiated liposarcoma and undifferentiated pleomorphic sarcoma, including treatment feasibility, safety, and response durability.
Sara Lonardi, MD, discusses the final overall survival analysis of CheckMate-8HW from ESMO 2026 and its implications for first-line MSI-H/dMMR mCRC.
The first-in-class oral RIPTAC molecule JNJ-6143 reached a 75% overall response rate and significant declines in PSA in metastatic castration-resistant prostate cancer.
Real-world study shows outpatient tarlatamab for relapsed SCLC is feasible, with mostly low-grade CRS, rare ICANS, low ICU use, and similar disease control.
Advertisement
Advertisement
Trending on Targeted Onc
1
A New Era in Sarcoma Treatment? Dr Banks on the Potential of TIL Therapy
2
FDA Approves Generic Venetoclax Tablets for CLL/SLL and AML
3
Enzalutamide Fails to Improve Survival in High-Risk Prostate Cancer
4
Neoadjuvant Botensilimab/Balstilimab Shows Activity in Colon Cancer
5