Evaluating rituximab maintenance therapy versus observation for follicular lymphoma

This study evaluated the effectiveness of rituximab (Rituxan) maintenance therapy for patients with follicular lymphoma (FL) after frontline treatment with BR (bendamustine, rituximab). This study concluded that rituximab maintenance is effective for these patients.

Chemoimmunotherapy containing rituximab remains the standard first-line (primary) treatment for patients with FL. Maintenance therapy with rituximab is often given to patients who have tumor shrinkage after initial treatment. On the other hand, observation or watchful waiting is more common for patients who do not have symptoms.

After initial treatment, many patients with FL have a risk of relapse. Maintenance therapy can help. This is a low-intensity therapy that is given for a long time. The goal of this therapy is to delay relapse rather than cure the cancer. The effectiveness of rituximab maintenance in patients with FL after initial treatment with BR chemoimmunotherapy remains under investigation.

This study involved 640 patients with follicular lymphoma. All patients were treated with BR. 357 patients received maintenance rituximab after initial treatment. 283 patients did not (observation group). Patients received maintenance rituximab for an average of 18 months. Patients were followed-up for an average of 36 months.

Overall, 66.0% of patients had a complete disappearance of all signs of cancer after BR therapy. 28.3% of patients had tumor shrinkage.

Significantly more patients who received maintenance therapy were still alive 3 years later without tumor growth or spread compared to patients who did not receive maintenance therapy (84.2% vs. 61.2%). Patients who had a complete disappearance of all signs of cancer had the highest rate of survival without tumor growth or spread at 3 years (84.5%).

95.4% of patients who had a complete disappearance of all signs of cancer were still alive 3 years later. This rate was 92.8% for patients who had tumor shrinkage after treatment.

This study concluded that rituximab maintenance is effective for patients with FL after treatment with BR. The authors suggest that patients who have tumor shrinkage after BR treatment particularly benefit.

This study was retrospective, meaning it looked back in time to analyze data. This may limit the conclusions that may be drawn from these results. More studies are needed to confirm these results.