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 will stand on its own, explaining what was studied, what was discovered, and what it could mean for patients, while the full series will offer a bigger-picture view of where the science is heading.
Our goal is simple: to make the latest research understandable, relevant, and useful to you.
When someone is diagnosed with follicular lymphoma, the first major decision is which treatment to start. Newer therapies are being tested earlier, but doctors still need long term data on these newer options to understand: how long responses last; what side effects look like over many years; and whether survival or quality of life improves.
Because this information is still developing, the most common first treatment remains immunochemotherapy. This combines:
This approach continues to work well for many people, offering high response rates and long remissions
A study from DanaFarber looked at 194 people treated between 2013-2024 with BR (bendamustine + rituximab) and found:
About 22% had POD24 – which means progression of disease within 24 months of starting treatment. POD24 is important because early relapse or progression is linked to a higher risk of poorer outcomes. More than half of the early progressions in this study were due to transformation, where FL changes into a faster growing lymphoma that needs different treatment. Transformed FL is reasonably unusual, affecting around 15% of all FL patients.
The Italian URBAN study looked at people receiving bendamustine (chemotherapy) + obinutuzumab (immunotherapy). Early results showed a low POD24 rate (9%), but follow up was short, and COVID19 related deaths made interpretation more difficult. Real world studies like this help researchers understand how treatments perform outside clinical trials.
Researchers explored whether PET scans at diagnosis could help predict risk of transformation (when the lymphoma becomes more aggressive and faster growing). PET scans measure how active cancer cells are. One measure is SUVmax, which reflects how much glucose a tumour is using. A high SUVmax (≥15) was linked to a higher chance of transformation over six years in one study, but other studies showed different results, so this is still uncertain.
Another measure, total metabolic tumour volume (TMTV), estimates the total amount of active lymphoma in the body. Early findings suggest TMTV may relate to outcomes like progression free survival, but more research is needed before it can guide treatment decisions.
Two genes commonly mutated in FL called EZH2 and CREBBP were evaluated to see whether they influenced which chemotherapy works best.
Researchers found:
Though not routinely used today, these findings suggest that in the future, genetic profiling has the potential to help guide chemotherapy choice. It also highlights that prognostic tools do not perform the same way in every situation and that outcomes can vary depending on the biology of the disease and the treatment used.
One of the most exciting developments is using bispecific antibodies earlier in the lines of treatment. These drugs bring together lymphoma cells to T cells (a type of immune cell), helping the immune system kill cancer more effectively. They are already successful in relapsed FL and are now being tested as first line therapy.
In the Morning Sun study, 103 FL patients with high-tumour burden were treated for one year with mosunetuzumab, and led to:
Side effects were generally manageable, though infections were common. Combination treatments showed even higher response rates, but follow up is still short. Researchers are also testing response adapted strategies, where treatment is only intensified if needed, to reduce unnecessary side effects.
Findings from ASH 2025 show that standard first-line chemo-immunotherapy continues to work well for many people, offering a strong and reliable first line option for many people with FL. Newer treatments like bispecific antibodies and tools such as genetic profiling are promising, but longer term data will help clarify how they may fit into first-line care in the future.
Treatment choices are personal and should be discussed with your healthcare team, who can help interpret how this research applies to your individual situation.
For the full technical report on ASH 2025 learnings, find our Chief Medical Officer’s article here:
Acknowledgements
These articles 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
