The Follicular Lymphoma Foundation (FLF)
CURE FL Awards

The FLF CURE FL awards

Therapeutic development initiatives to accelerate advanced and translational research

FL is a disease that for most runs a course of moving from periods of remission into relapse and back again and most patients experience multiple relapses over the course of their disease which can run for years or decades. For a small number of patients, the disease progresses earlier, and they can face 5-year survival rates as low as 50%. But like many cancers FL is genetically not just one disease, so to find cures will require a range of therapies to help a range of people. This rests on finding the right drug to be provided to the right patient at the right time.

The FLF are launching a suite of initiatives aimed to make curative therapies available to FL patients as soon as possible. The first initiative is the Follicular Lymphoma Foundation CURE FL Awards – Curative Research to Eliminate Follicular Lymphoma, launched in early 2022.

2022 CURE FL Awards – a focussed new initiative

The FLF exists for one purpose – to lead new and determined efforts to find better treatments and cures for FL. We are the first charity in the world solely focusing on follicular lymphoma and we are dedicated to finding a cure – and fast.

In pursuit of this mission the FLF CURE FL Awards is a focused new funding initiative under leadership of FLF Chief Medical Officer Dr Mitchell Smith and FLF scientific advisor Dr Jonathan Simons developed with The Milken Institute Center for Strategic Philanthropy and with the input and involvement of a wide range of experts in the field.

On the 10th January 2022 we published a call for proposals for innovative projects focusing in areas of treatment we have identified as being the most likely to deliver rapid progress towards cure. The funding programme is being delivered by the Milken Institute Center for Strategic Philanthropy.

The FLF CURE FL Awards 2022 is focussing on work in two areas as the most likely currently to lead to curative therapies available to FL patients as soon as possible: cellular immunotherapy, CAR-T (chimeric antigen receptor T cells) and others, and also targeted therapies either as stand-alone treatments or in combination with other treatments.

The programme is designed to encourage creative approaches to examining how these therapies can best be targeted towards cure in FL. Criteria for assessment will include the potential of any work funded to go into a clinical trial or be applied directly to patient treatment in the near term. We encourage potential applicants to think creatively and about high risk, high reward projects and the creation of cross functional/organisational teams.

Why this approach?

Outcomes for patients with FL have improved substantially over the last 40 years: the 5-year survival rate has increased from 65% in 1980 to 90% in 2021. However, nearly all patients experience relapse, often multiple relapses, over the course of their disease. A subset of patients experience early disease progression and face 5-year survival rates as low as 50%. Even patients with more favourable survival rates endure both the psychological toll of an incurable, relapsing disease and the increasing toxicities of therapies designated for later relapses.

Advances in understanding the biology of follicular lymphoma give us hope that curative therapies can be developed in the near future. The same advances also teach us that FL is a heterogeneous disease, so that such curative therapies will likely require having a tool kit containing various treatment options. Curative treatments and combinations will need to be individualised based on each person’s disease.

"Raising awareness to such a vast group of people could potentially make one person get that little lump checked."

Amy Beech

Potential applicants for the CURE FL Awards.

The 2022 CURE FL Awards are now closed for submission, and we will be making further announcements on the successful proposals later this year. Timeframes for the 2023 CURE FL Awards will also be made later this year.

To date, FL has rarely been the central focus for drug development: most drugs available to treat FL are also indicated for other lymphomas. By putting FL front and centre, this initiative will catalyse focused development of therapies for this still underserved patient population. Ultimately, the goal is to make curative therapies available to FL patients as soon as possible.

If you would like to read the 2022 programme prospectus for further background please download it and if you have any questions around this initiative please contact CureFL@milkeninstitute.org.

Why cellular therapies?

Cellular immunotherapy: Immunotherapy is believed to hold great promise for a curative effect. Immunotherapy treatments take advantage of the body’s natural defences to fight cancer.

Developments in immunotherapy have significant importance as an evolving approach to cancer therapy in general, and for FL specifically.

CAR-T is a form of immunotherapy. FL is a cancer of B lymphocytes. Lymphocytes are a type of white blood cell that is part of the immune system. There are other lymphocytes called T lymphocytes or T cells which are a part of the immune system that among many functions play a key role in killing cancer cells.

In FL, enhancing a patient’s T cell function shows great promise in helping eliminate FL.

T cells engineered in the lab to attack B lymphoma cells, called CAR-T cells, have already been tested in some FL patients.

CAR-T have produced a very high rate of clinical response in the clinical trial patients with relapsed or refractory FL, leading to approval for use in such patients, which is an exciting development. How long these responses will last remains to be determined. Also, for now CAR-T treatment is not suitable for all patients due to the risk of side-effects and it remains a complex procedure only available in limited centres.

Through the consultation process in designing the RFP this area of CAR-T and other engineered immune cells has been identified as a high priority for further investigation through the new FLF CURE FL Awards because of the success so far in this treatment area. Projects that make existing immune cells more effective in eradicating FL cells may be considered as well. There are many programmes currently focusing on CAR-T, but the FLF CURE FL Awards is different as it is asking for proposals only in relation to FL and only where there is a near term real world application that can have a direct clinical impact on improving outcomes of FL patients.

Why targeted therapies?

Targeted therapies are cancer treatments that use drugs to target specific genes and proteins that are involved in the growth and survival of cancer cells. Advances in understanding the biology of FL have shown a unique dependence of FL on epigenetic changes, meaning how a cell controls what genes are expressed rather than simply mutations in direct cancer-causing genes. This has led directly to a recent drug approval in FL for a targeted therapy called tazemetostat.

Through the work to develop the award a combination of epigenetically targeted therapies was identified as a priority area of focus that might advance the field, but more work needs to be done before we can individualize a given drug for a given patient. This is an area with great potential that because of the complexities has had little investment in for FL and so the FLF have prioritised it within the FLF CURE FL Awards programme to provide support to develop new epigenetic agents and combinations.