{"entity":{"id":"paper-prima-final-rituximab-maintenance-follicular-jco-2019","kind":"paper","name":"Sustained progression-free survival benefit of rituximab maintenance in patients with follicular lymphoma: long-term results of the PRIMA study","aka":["PRIMA final analysis","Bachy 2019"],"tldr":"After nine years the antibody maintenance group had gone more than six years longer before their lymphoma returned, and exactly as many people in each group were alive.","summary":"The final analysis of PRIMA after nine years of follow-up, with a data cut-off of 31 December 2016. 1,018 patients had been randomised to rituximab maintenance (505) or observation (513); 607 (59.6 per cent) consented to extended follow-up.\n\nMedian progression-free survival was 10.5 years in the maintenance arm against 4.1 years in the observation arm (hazard ratio 0.61, 95 per cent confidence interval 0.52 to 0.73). Overall survival did not differ (p = 0.7948), with ten-year estimates of approximately 80 per cent in both arms. No new safety signals were observed.","asOf":"2026-10-01","links":[{"label":"Journal of Clinical Oncology 2019","url":"https://doi.org/10.1200/JCO.19.01073"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/31339826/"},{"label":"Europe PMC","url":"https://europepmc.org/article/MED/31339826"}],"tags":["lymphoma-evidence"],"related":["paper-prima-rituximab-maintenance-follicular-lancet-2011","paper-casulo-pod24-follicular-lymphoma-jco-2015","lymphoma-roadmap"],"cancers":["follicular-lymphoma","non-hodgkin-lymphoma"],"sections":["immunotherapy"],"technologies":[],"targets":["cd20"],"drugs":["rituximab"],"companies":["lysa"],"institutions":[],"pathways":[],"terms":["maintenance-therapy","lymphoma-tx-maintenance","lymphoma-tx-pod24"],"trials":["prima-follicular"],"people":["gilles-salles"],"bottlenecks":["b-toxicity-qol","b-patient-voice"],"keyPapers":[],"journals":["jco"],"dependsOn":[],"notes":[],"journal":"Journal of Clinical Oncology","year":2019,"doi":"10.1200/JCO.19.01073","pmid":"31339826","authors":"Bachy E, Seymour JF, Feugier P, et al.","paperType":"rct","findings":["Median progression-free survival was 10.5 years with rituximab maintenance against 4.1 years with observation (hazard ratio 0.61, 95 per cent confidence interval 0.52 to 0.73).","Overall survival did not differ (p = 0.7948); ten-year estimates were approximately 80 per cent in both arms.","607 of 1,018 patients (59.6 per cent) consented to the extended follow-up.","No new safety signals were observed."],"whatItMeans":"The number to give a patient deciding about maintenance: a median of six and a half extra years before the next treatment, and no difference in how long they live. Both halves belong in the conversation.","caveats":["Only 59.6 per cent of randomised patients consented to extended follow-up, which could bias the long-term estimates in either direction.","Ten-year overall survival of about 80 per cent in both arms means the trial had limited power to detect a small survival difference.","The result predates the routine availability of bispecific antibodies and CAR-T at relapse, which change what the next treatment is worth."],"changedPractice":true,"participants":1018},"route":"/key-papers/paper-prima-final-rituximab-maintenance-follicular-jco-2019/","neighbours":{"paper":[{"id":"paper-casulo-pod24-follicular-lymphoma-jco-2015","kind":"paper","name":"Early relapse of follicular lymphoma after R-CHOP defines patients at high risk for death: an analysis from the National LymphoCare Study","route":"/key-papers/paper-casulo-pod24-follicular-lymphoma-jco-2015/"},{"id":"paper-prima-rituximab-maintenance-follicular-lancet-2011","kind":"paper","name":"Rituximab maintenance for 2 years in patients with high tumour burden follicular lymphoma responding to rituximab plus chemotherapy (PRIMA): a phase 3, randomised controlled trial","route":"/key-papers/paper-prima-rituximab-maintenance-follicular-lancet-2011/"}],"roadmap":[{"id":"lymphoma-roadmap","kind":"roadmap","name":"Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting","route":"/roadmaps/lymphoma-roadmap/"}],"cancer":[{"id":"follicular-lymphoma","kind":"cancer","name":"Follicular lymphoma","route":"/cancers/follicular-lymphoma/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"}],"section":[{"id":"immunotherapy","kind":"section","name":"Immunotherapy","route":"/fronts/immunotherapy/"}],"target":[{"id":"cd20","kind":"target","name":"CD20","route":"/targets/cd20/"}],"drug":[{"id":"rituximab","kind":"drug","name":"Rituximab","route":"/drugs/rituximab/"}],"company":[{"id":"lysa","kind":"company","name":"LYSA (The Lymphoma Study Association)","route":"/companies/lysa/"}],"term":[{"id":"lymphoma-tx-maintenance","kind":"term","name":"Maintenance and consolidation in lymphoma: where it works and where it does not","route":"/terms/lymphoma-tx-maintenance/"},{"id":"maintenance-therapy","kind":"term","name":"Maintenance therapy","route":"/terms/maintenance-therapy/"},{"id":"lymphoma-tx-pod24","kind":"term","name":"POD24: progression of follicular lymphoma within two years, and why it changes the plan","route":"/terms/lymphoma-tx-pod24/"}],"trial":[{"id":"prima-follicular","kind":"trial","name":"PRIMA","route":"/trials/prima-follicular/"}],"person":[{"id":"gilles-salles","kind":"person","name":"Gilles Salles","route":"/people/gilles-salles/"}],"bottleneck":[{"id":"b-patient-voice","kind":"bottleneck","name":"Patients lack understanding, navigation and agency","route":"/bottlenecks/b-patient-voice/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"journal":[{"id":"jco","kind":"journal","name":"Journal of Clinical Oncology","route":"/journals/jco/"}]}}