In a nutshell
This study evaluated the safety and effectiveness of rituximab (Rituxan) plus lenalidomide (Revlimid) for patients with previously untreated, advanced stage (stage 3 – 4) follicular lymphoma (FL). This study concluded that this regimen was similarly effective as rituximab plus chemotherapy, but had different side effects.
Chemoimmunotherapy containing rituximab remains the standard first-line (primary) treatment for patients with FL. However, this treatment is associated with side effects. Common side effects include immunosuppression (reduction of the activation or effectiveness of the immune system), heart-related side effects, and neuropathy (numbness or tingling in the hands and feet).
Lenalidomide is an immunomodulatory drug. This type of treatment boosts the body’s immune system to help it attack cancer cells. This leads to cancer cell death. The safety and effectiveness of lenalidomide combined with rituximab versus chemoimmunotherapy in patients with advanced-stage FL remain under investigation.
Methods & findings
This study involved 1030 patients with previously untreated, advanced stage FL. Patients received either rituximab plus lenalidomide (RL; 49.8%) or rituximab plus chemotherapy (RC; 50.2%). After treatment, patients received maintenance therapy (treatment to prevent relapse) with rituximab. Patients were followed-up for an average of 37.9 months.
Overall, 84% (RL) and 89% (RC) of patients responded to treatment. 59% (RL) and 67% (RC) of patients achieved a complete response (disappearance of all signs of cancer).
3-year progression-free survival (patients still alive 3 years later without tumor growth or spread) was similar (77% – RL and 78% – RC%). The probability of a complete response lasting for at least 3 years was 77% in the RL group and 81% in the RC group.
Overall, 99.8% (RL) and 99.0% (RC) of patients reported side effects. The most common ones included low red blood cell count (66% vs. 89%), fatigue (23% vs. 26%), and nausea (20% vs. 42%). Skin reactions (43% vs. 24%), diarrhea (37% vs. 19%), and rash (29% vs. 8%) were also common.
The bottom line
This study concluded that rituximab plus lenalidomide was similarly effective as rituximab plus chemotherapy, but had different side effects in previously untreated patients with FL.
The fine print
This study had a rather short follow-up period. Longer studies are needed to evaluate the long-term effects of this treatment.
Published By :
The New England Journal of Medicine
Sep 06, 2018
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