Editorial
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2023; 29(23): 3574-3594
Published online Jun 21, 2023. doi: 10.3748/wjg.v29.i23.3574
Recent advances in treatment of nodal and gastrointestinal follicular lymphoma
Takuya Watanabe
Takuya Watanabe, Department of Internal Medicine and Gastroenterology, Watanabe Internal Medicine Aoyama Clinic, Niigata-city 9502002, Japan
Author contributions: Takuya Watanabe solely contributes to this manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Takuya Watanabe, MD, PhD, Director, Doctor, Department of Internal Medicine and Gastroenterology, Watanabe Internal Medicine Aoyama Clinic, 1-2-21 Aoyama, Nishi-ku, Niigata-city 9502002, Japan. nabetaku@dia-net.ne.jp
Received: April 13, 2023
Peer-review started: April 13, 2023
First decision: May 12, 2023
Revised: May 14, 2023
Accepted: May 22, 2023
Article in press: May 22, 2023
Published online: June 21, 2023
Abstract

Follicular lymphoma (FL) is the most common low-grade lymphoma, and although nodal FL is highly responsive to treatment, the majority of patients relapse repeatedly, and the disease has been incurable with a poor prognosis. However, primary FL of the gastrointestinal tract has been increasingly detected in Japan, especially due to recent advances in small bowel endoscopy and increased opportunities for endoscopic examinations and endoscopic diagnosis. However, many cases are detected at an early stage, and the prognosis is good in many cases. In contrast, in Europe and the United States, gastrointestinal FL has long been considered to be present in 12%-24% of Stage-IV patients, and the number of advanced gastrointestinal cases is expected to increase. This editorial provides an overview of the recent therapeutic advances in nodal FL, including antibody-targeted therapy, bispecific antibody therapy, epigenetic modulation, and chimeric antigen receptor T-cell therapy, and reviews the latest therapeutic manuscripts published in the past year. Based on an understanding of the therapeutic advances in nodal FL, we also discuss future possibilities for gastroenterologists to treat gastrointestinal FL, especially in advanced cases.

Keywords: Nodal and gastrointestinal follicular lymphoma, Antibody-based therapy, Bispecific antibody therapy, Phosphatidylinositol-3 kinase inhibitor, Epigenetic modulator, Chimeric antigen receptor-T cell therapy

Core Tip: Primary gastrointestinal follicular lymphomas (FLs) have been increasingly detected in Japan, especially due to recent advances in small bowel endoscopy and increased opportunities for endoscopic examination and endoscopic diagnosis. Previously, many gastrolienal FL cases are detected at an early stage, however, the number of advanced cases is expected to increase in the future. This editorial provides an overview of the recent therapeutic advances in nodal FL, including antibody-targeted therapy, bispecific antibody therapy, epigenetic mutations, and chimeric antigen receptor T-cell therapy, and we also discuss future possibilities for gastroenterologists to treat gastrointestinal FL, especially in advanced cases.