My name is Carla Casulo. I'm an associate professor at the University of Rochester and I specialize in lymphoma. Today I debated against Peter Martin from Weill Cornell on the role of observation in the frontline treatment of follicular lymphoma. My position was arguments in favor of observation. We proposed arguments both in favor of observation and frontline treatment.
My position was that patients who have low-tumor burden follicular lymphoma, who are otherwise asymptomatic and that have no high-risk clinical or biologic features, are very appropriate for an observation approach, given that there are four large randomized studies that compared observations against chemotherapy and found absolutely no difference in overall survival.
So I think that while initial treatment with chemotherapy, in the right patient or rituximab for the right patient, certainly can have benefits in terms of lowering the risk of progression-free survival and possibly lowering the risk of transformation, overall survival remains the same.
That's incredibly important because patients with follicular lymphoma are living for over 20 years, and we have to really think about that when we are addressing toxicity of treatment and morbidity from treatment that could curtail their survival.
