Long-term follow-up of patients with follicular lymphoma receiving single-agent rituximab at two different schedules in trial SAKK 35/98.

  title={Long-term follow-up of patients with follicular lymphoma receiving single-agent rituximab at two different schedules in trial SAKK 35/98.},
  author={Giovanni Martinelli and S. F. Hsu Schmitz and Urs Utiger and T. Cerny and Urs Hess and Simona Bassi and E. Okkinga and Roger Stupp and Rolf Stahel and Marc Heizmann and Daniel A. Vorobiof and Andreas Lohri and Pierre-Yves Dietrich and Emanuele Zucca and Michele Ghielmini},
  journal={Journal of clinical oncology : official journal of the American Society of Clinical Oncology},
  volume={28 29},
PURPOSE We report the long-term results of a randomized clinical trial comparing induction therapy with once per week for 4 weeks single-agent rituximab alone versus induction followed by 4 cycles of maintenance therapy every 2 months in patients with follicular lymphoma. PATIENTS AND METHODS Patients (prior chemotherapy 138; chemotherapy-naive 64) received single-agent rituximab and if nonprogressive, were randomly assigned to no further treatment (observation) or four additional doses of… 

Rituximab Maintenance for a Maximum of 5 Years After Single-Agent Rituximab Induction in Follicular Lymphoma: Results of the Randomized Controlled Phase III Trial SAKK 35/03.

Long-term rituximab maintenance therapy does not improve EFS, which was the primary end point of this trial, or OS, and was associated with increased toxicity.

Prolonged rituximab maintenance in follicular lymphoma patients: long-term results of the SAKK 35/03 randomized trial.

It is indicated that single-agent rituximab may be a valid first-line option for symptomatic patients with advanced FL and no significant benefit of prolonged maintenance became evident with longer follow-up.

Sustained Progression-Free Survival Benefit of Rituximab Maintenance in Patients With Follicular Lymphoma: Long-Term Results of the PRIMA Study

  • E. BachyJ. Seymour G. Salles
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2019
Rituximab maintenance after induction immunochemotherapy provides a significant long-term PFS, but not OS, benefit over observation, and a final overview of safety is provided.

Rituximab induction immunotherapy for first-line low-tumor-burden follicular lymphoma: survival analyses with 7-year follow-up.

A significant proportion of patients remain progression-free 7 years after a single 4-dose rituximab treatment in first-line LTBFL, and the 7-year overall survivalOS is very high in this selected population of patients.

Chemotherapy-Free Initial Treatment of Advanced Indolent Lymphoma Has Durable Effect With Low Toxicity: Results From Two Nordic Lymphoma Group Trials With More Than 10 Years of Follow-Up.

Almost one third of patients with symptomatic indolent lymphoma did not need new therapy in the long term after first-line rituximab without chemotherapy, which suggests that chemotherapy can be delayed safely in the majority of patients.

Efficacy and safety assessment of prolonged maintenance with subcutaneous rituximab in patients with relapsed or refractory indolent non-Hodgkin lymphoma: results of the phase III MabCute study

Maintenance for up to 2 years with rituximab after response to initial induction therefore remains the standard of care in patients with relapsed or refractory indolent non- Hodgkin lymphoma.

Short regimen of rituximab plus lenalidomide in follicular lymphoma patients in need of first-line therapy.

Addition of lenalidomide to rituximab significantly improved CR/CRu rates, PFS, and TTNT, with higher but expected and manageable toxicity.

Two courses of four weekly infusions of rituximab with or without interferon-α2a: final results from a randomized phase III study in symptomatic indolent B-cell lymphomas

After a long median follow-up (61 months), 33% (42% of patients responding to cycle 1) were still failure-free with an overall survival rate of 88% and with no difference between the treatment groups.



Prolonged treatment with rituximab in patients with follicular lymphoma significantly increases event-free survival and response duration compared with the standard weekly x 4 schedule.

In patients with FL, the administration of 4 additional doses of rituximab at 8-week intervals significantly improves the EFS andCirculating normal B lymphocytes and immunoglobulin M plasma levels decreased for a significantly longer time after prolonged treatment, but the incidence of adverse events was not increased.

Rituximab as first-line and maintenance therapy for patients with indolent non-hodgkin's lymphoma.

Rituximab is highly active and extremely well tolerated as first-line single-agent therapy for indolent NHL and produces high overall and complete response rates and a longer progression-free survival than has been reported with a standard 4-week treatment.

Long-term molecular remissions in patients with indolent lymphoma treated with rituximab as a single agent or in combination with interferon alpha-2a: A randomized phase II study from the Nordic Lymphoma Group

Extended rituximab is effective and well tolerated and combination with IFN seems to improve both the quality and duration of the responses, providing the opportunity to achieve long-term molecular CRs and prolonged failure-free survival without chemotherapy.

Phase II trial of individualized rituximab dosing for patients with CD20-positive lymphoproliferative disorders.

Individualized PK dosing for rituximab produced efficacy comparable to other published maintenance strategies, and PK data from this trial suggest that a rational maintenance strategy in patients with LGNHL would be a single dose of 375 mg/m(2) of ritUXimab every 3 to 4 months.

Maximizing therapeutic benefit of rituximab: maintenance therapy versus re-treatment at progression in patients with indolent non-Hodgkin's lymphoma--a randomized phase II trial of the Minnie Pearl Cancer Research Network.

In patients who have objective response or stable disease with single-agent rituximab therapy, duration of ritUXimab benefit is substantially prolonged with either scheduled maintenance treatment or ritukimab re-treatment at the time of progression.

Patterns of survival in patients with recurrent follicular lymphoma: a 20-year study from a single center.

Age and previous and continuing responsiveness of follicular lymphoma to therapy are the principal determinants of survival following recurrence, with improvement in survival with new treatments most readily in older patients, while more intensive approaches should be tested in younger patients in whom remission is achieved with difficulty.

High-dose therapy followed by autologous purged stem cell transplantation and doxorubicin-based chemotherapy in patients with advanced follicular lymphoma: a randomized multicenter study by the GOELAMS with final results after a median follow-up of 9 years.

The occurrence of a PFS plateau suggests that a subgroup of patients might have their FL cured by ASCT, however, the increased rate of secondary malignancies may discourage the use of purged ASCT in combination with TBI as first-line treatment for FL.

Standard chemotherapy with interferon compared with CHOP followed by high-dose therapy with autologous stem cell transplantation in untreated patients with advanced follicular lymphoma: the GELF-94 randomized study from the Groupe d'Etude des Lymphomes de l'Adulte (GELA).

After long-term follow-up, the study showed that there was no statistically significant benefit in favor of first-line high-dose therapy in patients with follicular lymphoma and high- dose therapy should be reserved for relapsing patients.

Fludarabine, mitoxantrone, dexamethasone (FND) compared with an alternating triple therapy (ATT) regimen in patients with stage IV indolent lymphoma.

Both induction regimens followed by 1 year of interferon maintenance therapy were associated with high rates of response and survival and ATT was associated with substantially longer FFS, but it was more toxic than FND.