Study shows ‘as needed’ treatment better than maintenance therapy in follicular lymphoma

According to investigators with the USA’s Eastern Cooperative Oncology Group (ECOG), their study evaluating two different strategies for management of asymptomatic low-tumor-burden (LTB) follicular lymphoma (FL) patients found that, following an induction course of rituximab, repeated treatment with the therapy at time of progression is just as effective in managing the disease as ongoing maintenance therapy.

Brad S. Kahl, MD, Assistant Professor of Medicine at the University of Wisconsin in Madison, USA, and colleagues  compared the treatment strategies for 384 patients with previously untreated LTB FL. All patients received rituximab for four weeks; the 274 who achieved a complete or partial response were then randomized to MR (single dose of rituximab every three months, n=140) or RR (four weekly doses of rituximab at disease progression, n=134). Patients were evaluated every three months and followed until treatment failure. The average number of total doses in the MR arm was 15.8 per patient versus 4.5 doses per patient in the RR arm.

According to the ECOG investigators, their analysis showed that time to treatment failure was 3.9 years for MR-treated FL patients vs 3.6 years for RR-treated patients, rates longer than historical “watch and wait” strategies in that population. At three years of follow-up, 95% of MR patients had avoided cytotoxic therapy, as compared with 86% of RR patients.