Firmonertinib did not improve PFS in the phase 3 FURVENT trial in patients with EGFR Exon 20–Mutant NSCLC.
|Videos|June 19, 2020
A 77-Year-Old Man With Follicular Lymphoma
Author(s)Christopher R. Flowers, MD
Christopher Flowers, MD, describes the management of an elderly patient with relapsed follicular lymphoma using newer novel therapy.
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Case:A 77-Year-Old Man With Follicular Lymphoma
Initial Presentation
- A 77-year-old man complains of a 4-month history of occasional fevers, decreased appetite, and an unintentional 7-lbs. weight loss
- PMH: unremarkable
- PE: palpable left axillary lymph nodes ~ 4 cm; spleen palpable 4.5 cm below costal margin
Clinical Work-up
- Labs: ANC 1.5 x 109/L, WBC 10.6 x 109/L, 42% lymphocytes, Hb 10.1 g/dL, plt 100 x 109/L, LDH 325 U/L, B2M 3.3 µg/mL; HBV negative
- Follicular lymphoma grade 2
- Bone marrow biopsy showed lymphoid aggregates, 35% involvement
- Molecular genetics: t(14;18) (q32;q21)
- PET/CT showed enlargement of left axillary, mediastinal and bilateral para-aortic lymphadenopathy (4.2 cm, 5.3 cm, 3.6 cm and 3.5 cm respectively)
- Ann Arbor Stage IV; ECOG 0
Treatment
- He was treated with R-CHOP for 6 cycles; continued rituximab maintenance 375 mg/m3; achieved partial response
- 6 months later he complained of increasing frequency of fevers
- Repeat PET/CT revealed progression of disease
- He was started on bendamustine + obinutuzumab for 6 cycles and continued maintenance obinutuzumab
- Repeat lymph node biopsy grade 2 follicular lymphoma
- 8 months later he complained of increased weight loss
- He was started on idelalisib 150 mg PO BID
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