Journal Article

Maintenance rituximab in Veterans with follicular lymphoma

Morreall, Deborah, Dawson, Keith, Masaquel, Anthony, Henderson, Kevin, Rasmussen, Kelli M., Sauer, Brian C., Li, Catherine, Yong, Christina, Halwani, Ahmad S., Patil, Vikas, Burningham, Zachary, DeLong‐Sieg, Elisha

2020

Overview

Real‐world practice patterns and clinical outcomes in patients with follicular lymphoma (FL), including the adoption of maintenance rituximab (MR) therapy in the United States (US), have been reported in few studies since the release of the National LymphoCare Study almost a decade ago. We analyzed data from the largest integrated healthcare system in the United States, the Veterans Health Administration (VHA), to identify rates of adoption and effectiveness of MR in FL patients after first‐line (1L) treatment. We identified previously untreated patients with FL in the VHA between 2006 and 2014 who achieved at least stable disease after chemoimmunotherapy or immunotherapy. Among these patients, those who initiated MR within 238 days of 1L composed the MR group, whereas those who did not were classified as the non‐MR group. We examined the effect of MR on progression‐free survival (PFS) and overall survival (OS). A total of 676 patients met our inclusion criteria, of whom 300 received MR. MR was associated with significant PFS (hazard ratio [HR]=0.55, P < .001) and OS (HR = 0.53, P = .005) compared to the non‐MR group, after adjusting by age, sex, ethnicity, geographic region, diagnosis period, stage, grade at diagnosis, hemoglobin, lactate dehydrogenase (LDH), Charlson comorbidity index (CCI), 1L treatment regimen, and response to 1L treatment. These results suggest that in FL patients who do not experience disease progression after 1L treatment in real‐world settings, MR is associated with a significant improvement in both PFS and OS. Maintenance therapy should be considered in FL patients who successfully complete and respond to 1L therapy. MR is associated with a significant improvement in both PFS and OS. Maintenance therapy should be considered in FL patients who successfully complete and respond to 1L therapy.

• Publisher: John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
• Subject: Aged / Aged, 80 and over / Antineoplastic Agents, Immunological - administration & dosage / Antineoplastic Agents, Immunological - adverse effects / Antineoplastic Agents, Immunological - therapeutic use / Bias / Blood cancer / Chemotherapy / Clinical Cancer Research / clinical observations / Clinical trials / Comorbidity / Demographics / Diagnosis / epidemiology / Ethnicity / Female / haematological cancer / Hematology / Hemoglobin / Humans / Immunotherapy / Kaplan-Meier Estimate / L-Lactate dehydrogenase / Lactic acid / Lymphoma / Lymphoma, Follicular - diagnosis / Lymphoma, Follicular - drug therapy / Lymphoma, Follicular - epidemiology / Lymphoma, Follicular - mortality / Maintenance Chemotherapy / Male / Medical prognosis / Middle Aged / Monoclonal antibodies / Neoplasm Grading / Neoplasm Staging / Oncology / Original Research / Patients / Prognosis / Rituximab / Rituximab - administration & dosage / Rituximab - adverse effects / Rituximab - therapeutic use / SEER Program / Survival / Targeted cancer therapy / Treatment Outcome / Variables / Veterans / Veterans Health - statistics & numerical data