Evidence map›Paper›PMID 41453809›Full record

ReviewEuropean journal of haematology2026

Chemotherapy-Sparing Strategies in Follicular Lymphoma: Emerging Targeted and Immune-Based Approaches.

Enrica Antonia Martino, Santino Caserta, Mamdouh Skafi, Maria Eugenia Alvaro, Antonella Bruzzese, Nicola Amodio, Eugenio Lucia, Virginia Olivito, Caterina Labanca, Francesco Mendicino and 3 more

Abstract readReview
In one paragraph

Review in European journal of haematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Enrica Antonia MartinoHematology Unit, Department of Onco-Hematology, AO of Cosenza, Cosenza, Italy.
Santino CasertaHematology Unit, Department of Onco-Hematology, AO of Cosenza, Cosenza, Italy.
Mamdouh SkafiEmergency and Internal Medicine Department, Saint Joseph Hospital, East Jerusalem, Palestine.
Maria Eugenia AlvaroHematology Unit, Department of Onco-Hematology, AO of Cosenza, Cosenza, Italy.
Antonella BruzzeseHematology Unit, Department of Onco-Hematology, AO of Cosenza, Cosenza, Italy.
Nicola AmodioDepartment of Experimental and Clinical Medicine, University of Catanzaro, Catanzaro, Italy.
Eugenio LuciaHematology Unit, Department of Onco-Hematology, AO of Cosenza, Cosenza, Italy.
Virginia OlivitoHematology Unit, Department of Onco-Hematology, AO of Cosenza, Cosenza, Italy.
Caterina LabancaHematology Unit, Department of Onco-Hematology, AO of Cosenza, Cosenza, Italy.
Francesco MendicinoHematology Unit, Department of Onco-Hematology, AO of Cosenza, Cosenza, Italy.ORCID https://orcid.org/0000-0001-6339-632X
Ernesto VignaHematology Unit, Department of Onco-Hematology, AO of Cosenza, Cosenza, Italy.
Fortunato MorabitoAIL Sezione di Cosenza, Cosenza, Italy.
Massimo GentileHematology Unit, Department of Onco-Hematology, AO of Cosenza, Cosenza, Italy.ORCID https://orcid.org/0000-0002-5256-0726

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Follicular lymphoma (FL), traditionally considered an indolent yet incurable malignancy, is experiencing a substantial evolution in its therapeutic landscape with the emergence of chemo-free treatment strategies. These novel approaches challenge conventional chemotherapy-based paradigms and offer promising alternatives for both newly diagnosed and relapsed/refractory (RR) FL patients. Among these innovations, bispecific antibodies (BsAbs) have demonstrated compelling efficacy while providing practical advantages, including outpatient administration and generally manageable safety profiles. Chimeric antigen receptor (CAR) T-cell therapies have further expanded the therapeutic armamentarium, achieving unprecedented response rates in heavily pretreated and high-risk populations, although their implementation remains limited by logistical complexity and high associated costs. Additional targeted agents-such as Enhancer of zeste homolog 2 (EZH2) inhibitors, lenalidomide, and Bruton tyrosine kinase (BTK) inhibitors-also contribute meaningfully to chemo-free treatment options, particularly within combination regimens that may enhance clinical benefit. Despite these advances, several challenges persist. Early disease progression (POD24) remains one of the most powerful prognostic determinants in FL. The FLIPI-C model, incorporating machine-learning-derived risk stratification, has shown promise in identifying high-risk patients who may benefit most from innovative approaches. Introducing chemo-free therapies earlier in the treatment algorithm may improve outcomes for these patients while mitigating the long-term toxicities associated with conventional chemotherapy. Ongoing validation through prospective clinical trials and real-world evidence will be essential to define the optimal integration of these therapies. Overall, this evolving paradigm highlights the urgent need for continued innovation, multidisciplinary collaboration, and equitable access to ensure that the full potential of chemo-free strategies can be realized for patients with this complex disease.

Indexed as

Lymphoma, FollicularMolecular Targeted TherapyAntineoplastic Combined Chemotherapy ProtocolsCombined Modality TherapyDisease ManagementHumansPrognosisTreatment Outcomechemo‐free strategyfollicular lymphomatarget therapy

Identifiers

PMID41453809
PMCPMC12958793

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.