In a nutshell
This study reported the effectiveness and safety of longer rituximab (Rituxan) maintenance therapy schedules (more than 2 years) for the treatment of patients with relapsed or refractory (r/r) indolent (painless) non-Hodgkin lymphoma (iNHL). The data showed that maintenance for up to 2 years with rituximab after response to initial induction remains the standard of care in patients with r/r iNHL.
Some background
Non-Hodgkin lymphoma (NHL) is a cancer that starts in white blood cells called lymphocytes, which are part of the body’s immune system. Indolent non-Hodgkin lymphoma (iNHL) is a type of NHL that grows and spreads slowly and usually has very few symptoms. Treatment of iNHL usually involves treatment with immunotherapies such as rituximab alone or combined with chemotherapy. However, a high number of patients with iNHL experience relapse (worsening of the disease) or refractory (not responsive to the treatment) disease.
Maintenance therapy is long-term treatment with an anti-cancer drug at a lower dose after initial response to treatment. This can help prevent relapse. Rituximab plus chemotherapy induction followed by rituximab maintenance has shown benefits in terms of survival outcomes in patients with iNHL. Subcutaneous (SC; injection under the skin) rituximab plus chemotherapy has been shown to be more convenient for patients. However, it is not known whether longer SC rituximab maintenance therapy schedules (more than 2 years) provide additional benefits for patients with r/r iNHL.
Methods & findings
This study involved 276 patients with r/r iNHL. All patients responded to induction therapy with rituximab plus chemotherapy. The patients were randomly assigned to receive either rituximab maintenance for up to 2 years followed by observation (group 1) or extended maintenance with rituximab for more than 2 years (group 2). The average follow-up time was 28.1 months.
Patients in group 2 were 24% more likely to survive without progression or cancer worsening than patients in group 1. However, this difference was not considered significant.
The most common side effects were low white blood cell counts and pneumonia. These side effects were seen slightly more frequently in group 2 than in group 1.
The bottom line
The authors concluded that maintenance for up to 2 years with rituximab after response to initial induction should remain the standard of care in patients with r/r iNHL.
The fine print
This study received funding from F. Hoffmann-La Roche Ltd, the manufacturers of rituximab. The induction chemotherapy varied among patients. This may have influenced the response to rituximab treatment.
Published By :
Haematologica
Date :
Jun 17, 2021
