In a nutshell
This study aimed to investigate the effectiveness of lenalidomide consolidation therapy after chemoimmunotherapy for patients with chronic lymphocytic leukemia.
This study concluded that this regimen improves outcomes for these patients.
Some background
Fludarabine (Fludara) is a chemotherapy used for the treatment of chronic lymphocytic leukemia (CLL). It can be used in combination with rituximab (Rituxan), an immunotherapy (it helps the immune system fight cancer) is an immunotherapy. This treatment regimen for CLL is known as chemoimmunotherapy.
Another chemoimmunotherapy regimen that can be used for CLL is the combination of fludarabine, rituximab, and cyclophosphamide (Cytoxan). Cyclophosphamide is another chemotherapy.
Consolidation therapy is a therapy used to kill cancer cells which remain after treatment. Lenalidomide (Revlimid) can be used as a consolidation therapy. It is unclear if lenalidomide would be beneficial to patients with CLL who receive chemoimmunotherapy.
Methods & findings
This study involved 342 patients with CLL who had not been treated. 123 patients received fludarabine and rituximab (FR group). 109 patients received FR and lenalidomide consolidation (FRL group). 110 patients received FR and cyclophosphamide (FCR group).
The progression-free survival (PFS) rates for each regimen were measured. The PFS rate is the length of time during and after treatment that a patient lives with the disease but it does not get worse. Patients were followed for an average of 73 months.
The 2-year PFS rate was 64% for the FR group, 72% for the FRL group and 74% for the FCR group. The median PFS for the FR group was 43 months. The median PFS for the FRL group was 61 months. The median PFS for the FCR group was 97 months.
The risk of death decreased over time for the FRL group and was lower than the FR group at later time points but not significantly different from the FCR group.
The bottom line
This study concluded that lenalidomide consolidation therapy after chemoimmunotherapy extends PFS for patients with CLL.
The fine print
This was a phase 2 clinical trial. Further larger trials are needed to establish the effectiveness of lenalidomide as a consolidation therapy.
Published By :
Blood advances
Date :
Jul 24, 2018
