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Two years of a tablet after chemotherapy delayed relapse in older people with aggressive lymphoma but did not help them live longer.
A randomised phase 3 trial in 650 patients aged 60 to 80 with previously untreated diffuse large B-cell lymphoma or another aggressive B-cell lymphoma who had reached a complete or partial response after six or eight cycles of R-CHOP. They received lenalidomide 25 mg daily for 21 days of each 28-day cycle for 24 months, or placebo.
At the primary analysis in December 2015, with a median follow-up of 39 months from randomisation, median progression-free survival was not reached with lenalidomide against 58.9 months with placebo (hazard ratio 0.708, 95 per cent confidence interval 0.537 to 0.933, p = 0.01). The result was consistent across subgroups by sex, age-adjusted International Prognostic Index, age, response quality after R-CHOP and positron emission tomography status at randomisation. With longer follow-up to October 2016 (median 52 months), overall survival was similar between the arms (hazard ratio 1.218, 0.861 to 1.721, p = 0.26). Grade 3 or 4 neutropenia occurred in 56 against 22 per cent and cutaneous reactions in 5 against 1 per cent.
A clean example of a progression-free survival benefit that did not become a survival benefit. Lenalidomide maintenance did not become standard practice after this trial, and the figures are the reason.
Shares Gilles Salles, Maintenance and consolidation in lymphoma: where it works and where it does not, LYSA (The Lymphoma Study Association), Maintenance therapy and the tag lymphoma-evidence.
Shares Gilles Salles, Maintenance and consolidation in lymphoma: where it works and where it does not, LYSA (The Lymphoma Study Association), Maintenance therapy and the tag lymphoma-evidence.
Shares Older and multimorbid patients are excluded and undertreated, Lenalidomide, Rituximab, 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 and the tag lymphoma-evidence.
Shares Gilles Salles, Maintenance and consolidation in lymphoma: where it works and where it does not, LYSA (The Lymphoma Study Association), Maintenance therapy and the tag lymphoma-evidence.
Shares Catherine Thieblemont, LYSA (The Lymphoma Study Association), Maintenance therapy, Rituximab and the tag lymphoma-evidence.
Shares R-CHOP (lymphoma chemoimmunotherapy), Rituximab, 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, Toxicity and quality of life are undervalued and the tag lymphoma-evidence.
Shares Maintenance and consolidation in lymphoma: where it works and where it does not, Maintenance therapy, Rituximab, 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 and the tag lymphoma-evidence.
Shares Older and multimorbid patients are excluded and undertreated, Rituximab, 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, Toxicity and quality of life are undervalued and the tag lymphoma-evidence.