Six-Year Results From RELEVANCE: Lenalidomide Plus Rituximab (R2) Versus Rituximab-Chemotherapy Followed by Rituximab Maintenance in Untreated Advanced Follicular Lymphoma

Author(s): Franck Morschhauser, MD, PhD1; Loretta Nastoupil, MD2; Pierre Feugier, MD, PhD3; Jean-Marc Schiano de Colella, MD4; Hervé Tilly, MD5; Maria Lia Palomba, MD6; Emmanuel Bachy, MD, PhD7; Christophe Fruchart, MD8; Edward N. Libby, MD9; Rene-Olivier Casasnovas, MD10; Ian W. Flinn, MD, PhD11; Corinne Haioun, MD12; Hervé Maisonneuve, MD13; Loic Ysebaert, MD, PhD14; Nancy L. Bartlett, MD15; Kamal Bouabdallah, MD16; Pauline Brice, MD17; Vincent Ribrag, MD18; Steven Le Gouill, MD, PhD19; Nicolas Daguindau, MD20; Stéphanie Guidez, MD21; Gian Matteo Pica, MD22; Alejandro Martín García-Sancho, MD, PhD23; Armondo López-Guillermo, MD24; Jean-François Larouche, MD25; Kiyoshi Ando, MD26; Maria Gomes da Silva, MD, PhD27; Marc André, MD28; Wu Kalung, MD29; Laurie H. Sehn, MD, MPH30; Koji Izutsu, MD, PhD31; Guillaume Cartron, MD, PhD32; Argyrios Gkasiamis, MD33; Russell Crowe, MA33; Luc Xerri, MD, PhD4; Nathan H. Fowler, MD2; and Gilles Salles, MD6
Source: 10.1200/JCO.22.00843 Journal of Clinical Oncology 40, no. 28 (October 01, 2022) 3239-3245
Original Article
Professional photo of Maem Hussein, MD

Dr. Maen Hussein's Thoughts

Confirming that RR can be an alternative to R chemotherapy as a first line therapy  in advanced stage follicular lymphoma.

ABSTRACT

The RELEVANCE trial (ClinicalTrials.gov identifier: NCT01650701) showed that lenalidomide plus rituximab (R2) provided similar efficacy to rituximab plus chemotherapy (R-chemo) in patients with advanced-stage, previously untreated follicular lymphoma (FL). We report the second interim analysis of the RELEVANCE trial after 6 years of follow-up. Patients with previously untreated grade 1-3a FL were assigned 1:1 to R2 or R-chemo, followed by rituximab maintenance. Coprimary end points were complete response (confirmed/ unconfirmed) at week 120 and progression-free survival (PFS). At median follow-up of 72 months, 6-year PFS was 60% and 59% for R2 and R-chemo, respectively (hazard ratio 5 1.03 [95% CI, 0.84 to 1.27]). Six-year overall survival was estimated to be 89% in both groups. Median PFS and overall survival were not reached in either group. Overall response after progression was 61% and 59%, and 5-year estimated survival rate after progression was 69% and 74% in the R2 and R-chemo groups, respectively. The transformation rate per year in the R2 and R-chemo groups was 0.68% and 0.45%, and secondary primary malignancies occurred in 11% and 13% (P 5 .34), respectively. No new safety signals were observed. R2 continues to demonstrate comparable, durable efficacy and safety versus R-chemo in previously untreated patients with FL and provides an acceptable chemo-free alternative.

Author Affiliations

1University of Lille, CHU Lille, Lille, France; 2The University of Texas MD Anderson Cancer Center, Houston, TX; 3Nancy University Hospital, Vandoeuvre-lès-Nancy, France; 4Institut Paoli Calmettes, CRCM, AMU, Marseille, France; 5Centre Henri Becquerel, Rouen, France; 6Memorial Sloan Kettering Cancer Center, New York, NY; 7Hospices Civils de Lyon and Claude Bernard Lyon 1 Université, Lyon, France; 8CH de Dunkerque, Dunkerque, France; 9University of Washington, Seattle, WA; 10CHU Dijon-Bourgogne, Dijon, France; 11Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; 12Henri Mondor Université Hôpital, UPEC, Créteil, France; 13Centre Hospitalier Départemental Vendée, La Roche-sur-Yon, France; 14Institut Universitaire du Cancer Toulouse-Oncopole, Toulouse, France; 15Washington University School of Medicine, St Louis, MO; 16Bordeaux University Hospital, Bordeaux, France; 17Hôpital Saint-Louis, Paris, France; 18Institut Gustave Roussy, Villejuif, France; 19Institut Curie, Paris, France; 20Annecy Hôpital, Annecy, France; 21CHU de Poitiers, Poitiers, France; 22Centre Hospitalier Métropole Savoie Chambéry, Chambéry, France; 23Hospital Universitario de Salamanca, IBSAL, CIBERONC, Salamanca, Spain; 24Hospital Clínic de Barcelona, Barcelona, Spain; 25CHU de Québec, Québec, Canada; 26Tokai University School of Medicine, Kanagawa, Japan; 27Instituto Português de Oncologia de Lisboa, Lisboa, Portugal; 28CHU UCL Namur, Yvoir, Belgium; 29ZNA Stuivenberg, Antwerp, Belgium; 30BC Cancer Centre for Lymphoid Cancer, Vancouver, Canada; 31National Cancer Center Hospital, Tokyo, Japan; 32CHU Montpellier, Montpellier, France; 33Bristol Myers Squibb, Princeton, NJ

Leave a Comment

Your email address will not be published. Required fields are marked *

Related Articles

Phase III Trial of Pirtobrutinib Versus Idelalisib/Rituximab or Bendamustine/Rituximab in Covalent Bruton Tyrosine Kinase Inhibitor–Pretreated Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (BRUIN CLL-321)

Pirtobrutinib improved progression-free survival (PFS) to 14 months compared to 8 months with Idelalisib/Rituximab or Bendamustine/Rituximab (IdelaR/BR), with a hazard ratio of 0.54, in patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who had previously been treated with covalent BTK inhibitors (cBTKi). It also demonstrated favorable tolerability. With acalabrutinib and venetoclax emerging as preferred first-line therapies, Pirtobrutinib represents a strong second-line option for eligible patients.

Read More »

Zanubrutinib Versus Ibrutinib in Symptomatic Waldenström Macroglobulinemia: Final Analysis From the Randomized Phase III ASPEN Study

Final results from the ASPEN study confirm the strong long-term superiority of zanubrutinib over ibrutinib in symptomatic WM. While overall survival (OS) and progression-free survival (PFS) end-points are still to be reached, demonstrating the good prognosis of this disease, toxicities and response rates are much better with zanubrutinib. This is a cat-1 indication oof NCCN and a compelling option for use in this population.

Read More »
Load More