Follicular lymphoma
ICD-10 C82 · ICD-11 2A80

Relapsed Follicular Lymphoma Resistant to Rituximab (Rit-R)

This protocol addresses a specific and therapeutically challenging subset of follicular lymphoma: patients whose disease has relapsed and who meet the criteria for rituximab resistance.

Clinical Scenario

Rituximab resistance (Rit-R) is defined as no response to, or progression during or within 6 months after, treatment with rituximab or a rituximab-containing regimen. Therapeutic options for people with relapsed disease are more limited in this setting.

Treatment Approach

The protocol involves idelalisib, an oral targeted agent — a first-in-class selective inhibitor of PI3Kδ. This monotherapy approach has demonstrated meaningful activity in heavily pre-treated patients, including those who are Rit-R.

The complete regimen details, eligibility criteria, and supporting evidence are available in the full protocol.

References

Therapeutic options for people with relapsed disease are more limited for those who are resistant to rituximab (Rit-R), i.e., people who did not respond or who progressed during or within 6 months after treatment with rituximab or a rituximab-containing regimen.

Idelalisib is a first-in-class, selective, oral inhibitor of PI3Kδ.

At a dose of 100 mg twice-daily or more, responses are observed in approximately 45% of people with FL who have been heavily pre-treated, including those who are Rit-R and alkylator refractory, with the median PFS reported to be 16 months.

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