SOHO State of the Art Updates and Next Questions | Novel Immunotherapy Combinations for the Treatment of Indolent B-Cell Lymphoma.

Abstract

Chemoimmunotherapy (CIT) is the standard frontline treatment for advanced indolent non-Hodgkin lymphomas (iNHL). While lenalidomide-based immunotherapy remains the standard of care for relapsed iNHL, its frontline use is limited, due to nonsuperiority as compared to CIT. Agents that engage T-cells, polarize macrophage phenotype to a more antitumoral phenotype, and/or to target epigenetic pathways could enhance immunotherapy. We summarize in this review safety plus efficacy data from published and/or ongoing clinical trials investigating the combination of lenalidomide-based immunotherapy with T-cell engagers (including anti-CD3/CD20 bispecific antibodies), macrophage-targeting agents (including BTK inhibitors and anti-CD47 antibodies), and epigenetic modifiers (including EZH2 inhibitors). We also summarize the activity in iNHL of agents targeting antigens other than CD20 (including CD19 and CD79b), and novel immunotherapies and cellular therapies (including NK-cell based treatments). The therapeutic landscape of iNHL is soon to significantly change.