Optimizing First-Line Therapy for Follicular Lymphoma: Is It Time for Chemo-Free Therapy?

Follicular lymphoma (FL) is the most common subtype of indolent non-Hodgkin’s lymphoma (NHL) characterized by multiple recurrences requiring retreatment. Current research is focused on the development of a chemotherapy-free approach to improve clinical outcomes with fewer side effects than the conventional chemoimmunotherapy for the treatment of patients with newly diagnosed FL requiring immediate treatment. It is difficult for clinicians to stay abreast of the advances in treatment and clinical research for NHL.  The selection of a first-line therapy regimen should be highly individualized according to the patient’s age, extent of disease and the presence of comorbid conditions. Supportive care for treatment‑related complications should be an integral part of FL management to achieve full clinical benefit. Oncologists and hematologists need to maintain high awareness of these therapeutic advances and the precise indications for their use so that these new chemotherapy-free options can be incorporated in routine clinical practice in the appropriate patient population.

This information was originally presented at the NCCN 2019 Annual Congress: Hematologic Malignancies™  held in San Francisco, CA, on September 27-28, 2019.

Target Audience

This educational program is designed to meet the educational needs of the interprofessional oncology care team, including: physicians/oncologists, nurses, physician assistants, pharmacists, and other healthcare professionals who manage patients with cancer.

Learning Objectives

Following this program, participants should be able to:

  • Describe the standard first-line therapy and the rationale for the development of novel treatment options for follicular lymphoma.
  • Review the evidence from clinical trials supporting the use of a chemotherapy-free approach for the management of newly diagnosed follicular lymphoma.
  • Develop an individualized treatment plan for follicular lymphoma incorporating a chemotherapy-free approach based on the patient and disease-specific factors. 
Additional information

This activity is supported by educational grants from:

  • Agios Pharmaceuticals
  • AstraZeneca
  • BeiGene, Ltd.
  • Celgene Corporation
  • Coherus Biosciences
  • Genentech
  • Jazz Pharmaceuticals, Inc.
  • Pfizer Inc.
  • Pharmacyclics LLC, an AbbVie Company and Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC
  • Seattle Genetics, Inc.
  • Servier Pharmaceuticals, LLC
  • Takeda Oncology

This activity is supported by educational funding provided by Amgen.

This activity is supported by an independent educational grant from AbbVie.

This activity is supported by an unrestricted educational grant from Gilead Sciences, Medical Affairs.


Course summary
Available credit: 
  • 0.25 AAPA Category 1 CME credit
  • 0.25 ACPE contact hours
  • 0.25 AMA PRA Category 1 Credit™
  • 0.27 ANCC contact hours
  • 0.25 Participation
Course opens: 
Course expires: 

Richard I. Fisher, MD
Fox Chase Cancer Center

NCCN Medical Education Disclosure Policy
It is the policy of NCCN that every 12 months, all faculty, moderators, activity planners and all internal planning staff participating in NCCN continuing education activities are expected to disclose any financial relationships with a commercial interest as defined by the Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support. In addition, all faculty presentations have been reviewed for adherence to the ACCME’s Standards for Commercial Support (the provider develops activities/educational interventions independent of commercial interests [SCS 1, 2 and 6] by experts on the topics). 

Per the ACCME Standards for Commercial Support, individuals who do not disclose relevant financial relationships will be disqualified from involvement in the CE activity as a content developer, planner, or presenter. A complete list of individuals’ relationships with external entities is available upon request.

NCCN continuing education considers financial relationships to create a “conflict of interest” when an individual has both a financial relationship with a commercial interest and the opportunity to affect CE content about the products or services of a commercial interest with which he/she and/or a spouse or partner has a financial relationship.

NCCN continuing education considers “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. NCCN does not set a minimal dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship. 

Faculty Disclaimers  
All faculty for this continuing education activity are competent in the subject matter and qualified by experience, training, and/or preparation for the tasks and methods of delivery.

Faculty presentations may include discussion of off-label use. Faculty will disclose that the use in question is not currently approved by the FDA per the product labeling.

Faculty Disclosures 
The faculty listed below discloses the following relevant financial relationships:

Richard I. Fisher, MD
 Celgene Corporation: Consulting Fee
 prIME: Consulting Fee 

NCCN Staff Disclosures 

The NCCN Activity Planning staff listed below discloses no relevant financial relationships: 
Melissa Esplen; Mark A. Geisler; Kristina M. Gregory, RN, MSN, OCN; Kristin Kline Hasson; Rose Joyce; Karen Kanefield; Lisa Perfidio, MS; Shannon Ryan, CMP; Sarah Sinclair; Kathy Ann Smith, CHCP 

The NCCN Leadership listed below discloses no relevant financial relationships: 
Robert W. Carlson, MD; Wui-Jin Koh, MD; Gary J. Weyhmuller, MBA, SPHR  

The NCCN Clinical staff listed below discloses no relevant financial relationships: 
Mary A. Dwyer, MS, CGC; Hema Sundar, PhD 


 In support of improving patient care, National Comprehensive Cancer Network (NCCN) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

NCCN designates this enduring activity for a maximum of .25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

NCCN designates this educational activity for a maximum of .27 contact hours. 

NCCN designates this knowledge-based continuing education activity for .25 contact hours (0.025 CEUs) of continuing education credit. UAN: JA4008196-0000-19-100-H01-P

Physician Assistants 
NCCN has been authorized by the American Academy of PAs (AAPA) to award AAPA Catergory 1 CME credit for activities planned in accordance with AAPA CME criteria. This activity is designated for .25 AAPA Catergory 1 CME credits. Approval is valid until October 31, 2020. PAs should only claim credit commensurate with the extent of their participation. 

Available Credit

  • 0.25 AAPA Category 1 CME credit
  • 0.25 ACPE contact hours
  • 0.25 AMA PRA Category 1 Credit™
  • 0.27 ANCC contact hours
  • 0.25 Participation


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Required Hardware/software

To complete this activity, users will need: