Maintenance therapy with rituximab
halves risk of follicular lymphoma recurrence
The Phase III international PRIMA trial has found that
two years of rituximab maintenance therapy reduced the risk of follicular lymphoma
recurrence by 50 percent in patients who responded to initial chemotherapy.
"These findings provide hope for the way we manage
this disease. Rituximab maintenance therapy is likely to become a new standard
of care for these patients," said lead author Gilles Salles, M.D., professor
of medicine at the University of Lyon. He noted that most patients with this type
of lymphoma are at risk for a relapse within three to six years of their initial
therapy.
In this study, patients with primarily stage III or IV
follicular lymphoma whose disease was reduced or eliminated by rituximab-based
combination chemotherapy (induction therapy) were randomly assigned to receive
two additional years of rituximab as maintenance therapy (505 patients) or no
maintenance therapy (observation group, 513 patients).
After a median follow-up time of 25 months, disease progression
occurred in 18 percent of the rituximab group compared with 34 percent of the
observation group. The benefits of rituximab maintenance were observed regardless
of patients' stage of remission, age, or prior treatment regimen. The researchers
noted that longer follow-up of the patients is needed to confirm the benefits
of maintenance rituximab therapy for reducing the risk of lymphoma relapse.
Rituximab maintenance therapy was well tolerated, with
the most common side effects being infections (37 percent for the rituximab group
compared with 22 percent of the observation group). Quality of life was similar
between the two groups.
Based on these data, the manufacturer of rituximab has
applied for approval in the United States and Europe for an expanded indication
for rituximab as maintenance therapy in these patients.
Disclosures: Gilles Salles, Consultant or Advisory Role,
roche, Honoraria, roche, Research Funding, Genentech; John Seymour, Consultant
or Advisory Role, roche, Honoraria, roche, Other Remuneration, roche, Research
Funding, roche; Pierre Feugier, Consultant or Advisory Role, roche, Honoraria,
roche; David Belada, Honoraria, roche, Other Remuneration, roche.
This study was presented at ASCO's 46th Annual Meeting
in Chicago.
Research Funding Provided by: Roche Pharma
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