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Posted by on Aug 4, 2019 in Non-Hodgkin lymphoma | 0 comments

In a nutshell

This study looked at long-term outcomes for patients with follicular lymphoma after rituximab (Rituxan) maintenance therapy. This study concluded that rituximab maintenance helped improve long-term survival without disease progression compared to no treatment.

Some background

Follicular lymphoma (FL) is the second most common type of lymphoma in the US and Western Europe. Although treatments are effective, the cancer eventually comes back (relapse) for most patients with advanced-stage disease. Previous studies have shown that rituximab maintenance therapy can help.

Rituximab is a monoclonal antibody. This type of treatment targets cancer cells for attack by the body's own immune system. Maintenance therapy is long-term treatment with an anti-cancer drug at a lower dose. This can help prevent relapse. The long-term outcomes of rituximab maintenance therapy for patients with FL are under investigation.

Methods & findings

This study had 1018 patients with previously untreated FL. All patients received first-line chemoimmunotherapy. Patients were then divided into two groups. 505 patients received rituximab maintenance for 2 years. 513 patients had no additional treatment (observation group). Patients who gave consent were followed-up for an average of 9 years after treatment.

On average, patients on rituximab maintenance survived for significantly longer without tumor growth or spread compared to the observation group (10.5 years vs. 4.1 years). Rituximab maintenance therapy was significantly associated with a 39% increase in long-term survival without the cancer progressing.

Rituximab maintenance did not significantly improve overall survival 10 years later compared to observation only (80.1% vs. 79.9%). However, mortality due to secondary cancer was 4 times higher in the observation group compared to the maintenance group.

At follow-up, 503 patients had tumor growth or spread. Of these, 453 patients had second-line treatment. Significantly more patients in the observation group received treatment containing rituximab compared to the maintenance group (81.5% vs. 73.2%).

Overall, 56.9% (maintenance) and 38.2% (observation) of patients had at least one side effect. Significantly more patients on rituximab maintenance had serious side effects compared to the observation group (24.4% vs. 16.9%). The most common ones were seriously low blood cell counts (5.2% vs. 1.6%) and serious infections (4.4% vs. 1.0%).

The bottom line

This study concluded that patients treated with rituximab maintenance survived for significantly longer without disease progression compared to the observation group.

The fine print

Only 607 patients of the total 1,018 were followed up long-term due to consent not being obtained. The impact of rituximab maintenance on long-term overall survival needs further study.

Talk to your doctor about the potential benefits of rituximab maintenance therapy.

What’s next?

Talk to your doctor about the potential benefits of rituximab maintenance therapy.

Published By :

Journal of clinical oncology

Date :

Jul 24, 2019

Original Title :

Sustained Progression-Free Survival Benefit of Rituximab Maintenance in Patients With Follicular Lymphoma: Long-Term Results of the PRIMA Study.

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