In this “Science Simplified” series, we’ll be sharing insights from the latest research presented at the American Society of Hematology (ASH) conference in December 2025. Each article stands on its own, explaining what was studied, what was discovered, and what it could mean for patients, while the full series offers a bigger-picture view of where the science is heading.
Our aim is simple: to make the latest research understandable, relevant, and useful to you.
Living with FL often means living with uncertainty. Even when treatment is working, many people are left wondering what might happen next: whether the lymphoma could return early, transform into a more aggressive type, or stay under control for years.
Researchers are increasingly focused on finding ways to reduce this uncertainty. One promising and evolving area is the study of biomarkers. These are measurable signs in the body that may help predict how FL behaves over time. Better prediction could improve treatment decisions, but just as importantly, it could help reduce anxiety for patients and families.
POD24 (Progression of disease within 24 months of treatment), where the lymphoma comes back within two years of starting treatment. The other is transformation, when FL changes into a faster‑growing lymphoma.
If doctors could identify people at higher risk before these events occur, this might allow closer monitoring or different treatment approaches. At the same time, better prediction could also help identify people who are at lower risk. This line of research has received less attention, but may be equally important in improving how FL patient treatment and monitoring are planned.
An exciting area of research involves liquid biopsies. These blood tests look for tiny fragments of tumour DNA, known as circulating tumour DNA (ctDNA), or other molecules or protein fragments, released into the bloodstream by cancer cells.
Liquid biopsies are already used successfully in some aggressive lymphomas. Follicular lymphoma is more complex, shows a wider variety of features and is usually slower‑growing, which makes these signals much harder to detect. As technology and limits of detection improve, we are still seeing strong interest to develop the right tests.
In some clinical trials, liquid biopsies are being used to measure minimal residual disease (MRD). This refers to very small amounts of lymphoma that may remain after treatment, even when scans show no obvious disease. Tracking MRD could allow doctors to see how well a treatment is working earlier than traditional tests, and potentially make quicker decisions about next steps.
The Follicular Lymphoma Foundation is funding two studies, in partnership with the Mark Foundation for Cancer Research, that aim to identify biomarkers linked to response or resistance to newer treatments, including T‑cell engaging therapies. These projects are exploring whether blood‑based markers can help predict who will benefit most from specific treatments, and who may need alternative approaches. The project researchers from both studies are also sharing access to innovative technologies (advanced spatial omics) to map the genetic changes and microenvironment of FL tumours, both at diagnosis and after treatment.
Although this work is still developing, it represents an important move toward more personalised care in FL.
Much research has rightly focused on identifying high‑risk FL. But there is growing recognition that we also need to understand who does well over the long term, and whether we can reduce unnecessary worry for those patients.
Clues come from a large US study that followed more than 1,000 people diagnosed with FL between 2002 and 2015, with follow‑up extending to around 14 years. Overall survival remained high, with about 80% of people alive at 10 years and nearly two‑thirds at 15 years, despite many newer treatments not yet being available. Many patients needed little treatment over time: nearly one in three remained treatment‑free after diagnosis, and among those who did receive first‑line immunochemotherapy, around 60% never required a second treatment.
This has led researchers to cautiously suggest the idea of a “functional cure” for some people, although there is currently no test to identify who those individuals will be.
One of the most encouraging findings was how risk changed with time. Rates of progression, retreatment and transformation slowed significantly after around eight years. Transformation was most common in the first five years after diagnosis and became less frequent later on.
By around 13 years after diagnosis, particularly in people aged over 60, deaths unrelated to lymphoma became more common than deaths caused by the lymphoma itself. For many people, FL gradually becomes a less dominant part of their overall health picture.
These findings raise an important and hopeful question: could people who remain in remission for eight to ten years be reassured that their risk of poor outcomes has fallen substantially?
Researchers are now exploring whether future biomarkers could help confirm this lower‑risk state. If successful, this could offer not only better medical guidance, but real peace of mind for people who have lived with uncertainty for many years.
No single test can yet predict the future for someone with follicular lymphoma. But research into biomarkers and long‑term outcomes is steadily moving the field forward – toward better prediction, more personalised treatment, and greater reassurance.
For the full technical report on ASH 2025 learnings, find our Chief Medical Officer’s article here:
Acknowledgements
These “Science simplified” articles on the learnings from ASH 2025 are supported by sponsorship from AstraZeneca, Genmab, AbbVie, Ipsen and Incyte. All of the above have had no influence on, control of, nor input into the development or content of any article.
This article is for information purposes only, and we recommend that you speak with your healthcare team if you have any questions around suitability and regional accessibility of therapy options.
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