Aligning Treatment Goals in R/R FL: Physician vs Patient Perspectives

EP: 1.Overview of R/R FL: Focus on the 3rd-Line Setting and Beyond START

EP: 2.Managing 3rd-Line R/R FL: Recognizing Progression, Performing Rebiopsies, and Rechecking for CD20 Positivity

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EP: 3.Aligning Treatment Goals in R/R FL: Physician vs Patient Perspectives

EP: 4.Clinical Scenario: 73-Year-Old Patient With R/R FL Requires Treatment in the 3rd-Line Setting.

Summary for Physicians:

Topic: Treatment Goals in the Third-Line Setting for R/R FL

Key Points:

1. Physician Treatment Goals:
   1. In the third-line setting, the primary clinical goals often include the following:
      1. Achieving durable disease control
      2. Minimizing toxicity and preserving quality of life
      3. Avoiding rapid progression or transformation
      4. Delaying the need for additional lines of therapy
   2. Physicians also aim to select therapies that offer a favorable balance between efficacy and tolerability, particularly given patients’ prior exposure to treatments and cumulative toxicities.
2. Patient-Centered Goals and Expectations:
   1. Patients may prioritize different aspects of care depending on their experiences and disease burden. Common patient goals include the following:
      1. Maintaining independence and daily functioning
      2. Reducing symptom burden (eg, fatigue, discomfort from lymphadenopathy)
      3. Avoiding hospitalization or intensive therapies
      4. Minimizing adverse effects and treatment-related disruptions to lifestyle
3. Alignment and Shared Decision-Making:
   1. While there is often overlap between physician and patient goals, alignment is not always perfect. Open communication is essential to understand patient preferences, address misconceptions, and ensure that the chosen treatment plan reflects both clinical appropriateness and the patient’s values.
   2. Incorporating shared decision-making improves adherence, satisfaction, and overall outcomes.

Clinical Implication: In the third-line setting for R/R FL, physicians should balance treatment efficacy with quality-of-life considerations and actively engage in shared decision-making to ensure care is aligned with each patient's unique goals and expectations.