Induction therapy with lenalidomide plus rituximab may result in control that is comparable to rituximab plus chemotherapy for the initial treatment of patients with follicular lymphoma, a study published online ahead of print in the journal Annals of Oncology has shown.1

Because the optimal initial therapy of follicular lymphoma remains unclear, researchers at the University of Texas MD Anderson Center in Houston sought to compare primary treatment strategies, evaluate the impact of maintenance rituximab, and identify patterns of treatment failure.

For the study, researchers retrospectively analyzed data from 356 treatment-naïve patients with advanced-stage, grade 1-2 follicular lymphoma treated at their institution between 2004 and 2014.

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Participants were treated on clinical trials or standard-of-care with RCHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone), RCHOP with maintenance, bendamustine plus rituximab, bendamustine with maintenance, or lenalidomide plus rituximab.

Results showed that after a median follow-up of 4 years, the 3-year progression-free survival was 60% (95% CI: 51-69) for RCHOP, 72% (95% CI: 59-82) for RCHOP with maintenance, 63% (95% CI: 42-78) for bendamustine plus rituximab, 97% (95% CI: 80-100) for bendamustine plus ritxuimab with maintenance, and 87% (95% CI: 78-93) for lenalidomide plus rituximab.

Researchers found that treatment with lenalidomide plus rituximab was associated with superior progression-free survival compared with RCHOP (HR, 0.39; 95% CI: 0.17-0.89; P=.02).

The study also demonstrated that early disease progression within 2 years (HR, 5.1; 95% CI: 1.57-16.83) and histologic transformation (HR, 11.05; 95% CI: 2.84-42.93) are predictive of inferior survival in this patient population.


  1. Cheah CY, Chihara D, Ahmed M, et al. Factors influencing outcome in advanced stage, low-grade follicular lymphoma treated at MD Anderson Cancer Center in the rituximab era [published online ahead of print January 22, 2016]. Ann Oncol. doi:10.1093/annonc/mdw026.