Clinical Scenario: A 73-Year-Old Patient With R/R FL Requires Treatment in the Third-Line Setting

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

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

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

EP: 5.Expert Perspectives: Tazemetostat in R/R FL

EP: 6.Choosing Between Tazemetostat and Zanubrutinib+Obinutuzumab: Key Factors & Patient Conversations

EP: 7.Assessing CAR T and Bispecifics for R/R FL: Identifying the Right Candidates & Factoring in CD20 and CD19 Negativity or Positivity

EP: 8.Navigating Treatment Choices in R/R FL: Patient Values and Shared Decision-Making

EP: 9.Managing R/R FL: Evolving Sequencing Strategies

EP: 10.Key Strategies and Perspectives: How Novel 2nd-Line Therapy Options May Impact 3rd-Line Treatment Landscape in R/R FL and Bridging Strategies to CAR T

EP: 11.Collaborating With Community Providers in Treating Patients With Complex R/R FL

EP: 12.Looking Ahead in R/R FL: Unmet Needs and What’s Next

EP: 13.Physician Assistant Perspectives: Aligning Patient Goals in R/R FL and Navigating Third-Line Treatment Options

EP: 14.Physician Assistant Perspectives: Importance of Patient Shared Decision-Making and Multidisciplinary Team Approach in R/R FL

EP: 15.Physician Assistant Perspectives: When to Consider Tazemetostat in R/R FL

Summary for Physicians:

Topic: Clinical Approach to an R/R FL Case in the Third-Line Setting

Key Points:

1. Initial Impressions:
   1. When evaluating a patient in the third-line setting, key clinical considerations include the following:
      1. Disease biology and pace of relapse (indolent vs more aggressive)
      2. Duration and quality of response to prior lines of therapy
      3. Presence of symptoms, comorbidities, and overall performance status
      4. Any prior exposure to specific agents (eg, anti-CD20 therapies, alkylating agents, or PI3K inhibitors)
2. Treatment Considerations:
   1. Treatment in the third-line setting would be personalized based on the following:
      1. Patient’s fitness and treatment goals
      2. Previous treatment responses and toxicities
      3. Current disease burden and symptomatology
   2. Options may include novel agents (eg, EZH2 inhibitors or bispecific antibodies), clinical trial enrollment, or cellular therapies in select cases.
   3. In some patients, retreatment with prior regimens may be appropriate if previous responses were durable and well tolerated.

Clinical Implication: A thoughtful, individualized approach is essential when managing R/R FL in the third-line setting. Reviewing disease course, patient status, and available therapies helps guide optimal treatment planning and ensures alignment with patient goals.