Alternative regimen for chemotherapy–intolerant lymphoma including practical aspects in Japan

Traditional approaches include dose reduction (e.g. mini-CHOP) or non-anthracycline regimens (e.g. CVP or bendamustine-based regimens) to reduce the risk of cardiotoxicity. A recent trend is the combination of molecular-targeted agents, such as lenalidomide plus rituximab in B-cell lymphoma. However, maintaining durable responses remains a major challenge. In the future, clinical trials in elderly or frail patients are expected to investigate novel agents such as antibody-drug conjugates or bispecific T-cell engagers. In addition, comprehensive geriatric assessment for tailored therapeutic intervention or dose optimization strategies based on individual genomic data is expected in the context of prospective studies.