Making Treatment Choices: Deciding Between Therapy Types for Follicular Lymphoma

By working together in an informed and collaborative manner, patients and their doctors can determine the approach that offers the best balance of efficacy, safety, and long-term well-being.

“There are lots of different therapies that will be needed during the course of an incurable indolent disease,” Dr. Steven Stein, Chief Medical Officer at Incyte, tells SurvivorNet.

“If you look at follicular lymphoma, even now in the real world, there’s multiple therapies and chemotherapies used, including monoclonal antibodies, bispecific antibodies, CAR T cellular therapy … each with a slightly different mechanism of action, different efficacy profiles, and different safety profiles,” he explains.

Tailoring Treatment Choices: Physician and Patient Collaboration

The treatment path a patient takes will depend on several factors — and it’s important for patients to feel they can collaborate and share their personal preferences with their medical team.

“The right place for those therapies will be decided by physicians in conjunction with their patients based on their available data and if they are approved based on the label that they get from the FDA. And often, it’s both an efficacy decision as well as the safety decision because people have had prior therapies, they have different comorbidities, different diseases, some can tolerate different things versus others,” Dr. Stein adds.

This collaboration often starts with a conversation about what’s most important to the patient: Is it controlling symptoms with minimal side effects? Achieving the longest possible period without disease progression? Preserving the quality of life during and after treatment? By focusing on these priorities, the physician and patient can weigh treatment options that align with individual needs.

Understanding Clinical Results

Deciding between drugs often involves interpreting complex clinical data. Concepts like Progression-Free Survival (PFS) and tools like Kaplan-Meier curves are crucial in understanding how treatments perform over time. PFS refers to how long patients live without the disease worsening. The Kaplan-Meier curve is a statistical method used to estimate how likely it is that patients will remain in remission or avoid progression at various time points.

By examining these graphs and survival curves, doctors can more clearly explain the potential outcomes of different treatments, helping patients visualize how therapy might lead to their future. If you are unsure what these data mean for you personally, ask your doctor for additional context. Making treatment plans should be a collaborative effort.

“We throw around things like median PFS, and what does it really mean? It’s a single point on a curve and it’s hard to translate that to a patient to try and describe what potential benefit they may get from a therapy,” Dr. Stein explains. “We throw around a response rate that says you’ve got an ‘X’ chance of responding … I think you have to make it tangible and meaningful for patients. That’s why I think visuals are important. So, if you look at progression-free survival curves and we use something statistically called a Kaplan-Meier method and you generate the curves for patients, you get a sense of the totality of the data.”

In the end, deciding between the various therapy types for follicular lymphoma is about more than just selecting a drug or regimen — it’s about building a strategy that respects each patient’s life, values, and aspirations. With meaningful data, expert guidance, and open dialogue, patients and physicians can dive on a treatment path that feels both scientifically grounded and personally right.

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