# AUGMENT: lenalidomide plus rituximab versus rituximab alone in relapsed indolent lymphoma

Source: https://onco.cc/key-papers/paper-augment-lenalidomide-rituximab-leonard-jco-2019/  
OnCo record `paper-augment-lenalidomide-rituximab-leonard-jco-2019` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adding lenalidomide to rituximab more than doubled the time to progression in relapsed follicular and marginal zone lymphoma compared with rituximab alone, establishing a chemotherapy-free option for relapsed indolent lymphoma.

## Summary

Phase 3 trial of 358 patients with relapsed or refractory follicular (grade 1 to 3a) or marginal zone lymphoma randomised to lenalidomide plus rituximab (R2) or placebo plus rituximab for 12 cycles.

Median progression-free survival was 39.4 versus 14.1 months (hazard ratio 0.46) and response 78 versus 53 percent; the benefit was clear in follicular lymphoma while the marginal zone subgroup was small and inconclusive. Neutropenia was more frequent with lenalidomide.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Journal of Clinical Oncology
- Year: 2019
- DOI: 10.1200/JCO.19.00010
- Authors: Leonard JP, Trneny M, Izutsu K, et al.
- Findings: Median progression-free survival 39.4 vs 14.1 months; hazard ratio 0.46.; Objective response 78 percent vs 53 percent.
- What it means: Lenalidomide-rituximab is approved for relapsed follicular and marginal zone lymphoma and is a standard chemotherapy-free choice, though marginal zone-specific evidence is thinner.
- Caveats: Only 63 patients had marginal zone lymphoma, with no clear progression-free survival benefit in that subgroup.

## Sources

- J Clin Oncol 2019: https://doi.org/10.1200/JCO.19.00010
- PubMed: https://pubmed.ncbi.nlm.nih.gov/30897038/

## Connected records

- cancers: [Marginal zone lymphoma](https://onco.cc/cancers/marginal-zone-lymphoma/)
- drugs: [Lenalidomide](https://onco.cc/drugs/lenalidomide/), [Rituximab](https://onco.cc/drugs/rituximab/)
- trials: [AUGMENT](https://onco.cc/trials/augment/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)

---
JSON: https://onco.cc/api/v1/entities/paper-augment-lenalidomide-rituximab-leonard-jco-2019.json