Lenalidomide and rituximab for relapsed/refractory follicular lymphoma: a systematic review and meta-analysis

Résumé fourni par la source

Lenalidomide (len) and rituximab (R 2 ) is standard second-line therapy for follicular lymphoma (FL), and the backbone and comparator for several new therapies. This systematic review and meta-analysis of R 2 or len-anti-CD20 monoclonal antibodies aims to clarify efficacy across trials, and to evaluate the benefit of triplet therapies including R 2 . Across 24 treatment arms involving 2245 patients, 63% received R 2 or len-anti-CD20 and 37% received it with an additional agent. For R 2 /len-anti-CD20, the overall response rate (ORR) was 75.9% (95% CI 72.1–79.3, p = 0.0092; I 2 = 53.5%), and complete response rates (CR), 39.6% (95% CI 32.4–47.3, p < 0.0001, I 2 = 73.2%). ORRs were similar whether studies included or excluded rituximab-refractory, but CR appeared lower (28.6% vs. 42.9%). The number of prior lines of therapy did not affect response. Adding a third agent to R 2 or len-anti-CD20 resulted in similar ORRs but significantly higher CR and 1- and 2-year progression-free survival appeared longer than that seen with R 2 . However, triplet regimens were associated with increased grade ≥3 toxicity. These findings reinforce the role of R 2 in R/R FL in the modern treatment era. R 2 at first relapse is effective across rituximab sensitivity profiles. Triplet combinations built on the R 2 backbone improve efficacy but require careful patient selection and monitoring due to higher toxicity risks.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.