Lenalidomide: A Review in Previously Treated Follicular Lymphoma
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ADIS DRUG EVALUATION
Lenalidomide: A Review in Previously Treated Follicular Lymphoma Hannah A. Blair1
© Springer Nature Switzerland AG 2020
Abstract Lenalidomide (Revlimid®) is a targeted immunomodulatory drug with multiple mechanisms of action. In the USA and the EU, oral lenalidomide is indicated in combination with rituximab or a rituximab product for the treatment of patients with previously treated follicular lymphoma. In the pivotal, phase III AUGMENT trial, lenalidomide + rituximab significantly prolonged progression-free survival (PFS; primary endpoint) relative to placebo + rituximab in patients with relapsed or refractory indolent non-Hodgkin lymphoma, with the PFS benefit appearing to be specific to patients with follicular lymphoma and extending to elderly patients with this subtype. Lenalidomide + rituximab also demonstrated activity in an interim analysis of the phase III MAGNIFY trial in patients with relapsed or refractory indolent non-Hodgkin lymphoma, including those with rituximab-refractory disease. Lenalidomide had an acceptable tolerability profile. Although grade 3 or 4 neutropenia occurred more frequently with lenalidomide + rituximab than with placebo + rituximab, this was generally well managed with dosage adjustments and growth factor support. In conclusion, lenalidomide in combination with rituximab represents an important new treatment option for previously treated follicular lymphoma, including patients whose disease has become refractory to rituximab.
Lenalidomide: clinical considerations in previously treated follicular lymphoma Immunomodulatory agent with multiple mechanisms of action Lenalidomide + rituximab significantly prolongs PFS relative to placebo + rituximab Improves response rates, duration of response, event-free survival, time to next treatment and time to next chemotherapy Acceptable tolerability profile Enhanced material for this Adis Drug Evaluation can be found at https://doi.org/10.6084/m9.figshare.12762095. The manuscript was reviewed by: D. Dierickx, Department of Hematology, University Hospitals Leuven, Leuven, Belgium; S. Gonzalez, Hematology, University Hospital Marqués de Valdecilla, Santander, Spain; P. Scheinberg, Division of Hematology, Hospital A Beneficencia Portuguesa de São Paulo, São Paulo, Brazil. * Hannah A. Blair [email protected] 1
Springer Nature, Private Bag 65901, Mairangi Bay, Auckland 0754, New Zealand
1 Introduction Follicular lymphoma is one of the most common subtypes of indolent non-Hodgkin lymphoma [1, 2]. Although the disease is not considered to be curable [1], overall survival (OS) has improved considerably since the introduction of the anti-CD20 monoclonal antibody rituximab [2], the first immunotherapy drug used to treat lymphoma. Most patients with follicular lymphoma currently receive first-line induction therapy with a rituximab-containing regimen, followed by rituximab maintenance therapy [3]. While patients usually respond to initial therapy, the majority still relapse and eventually develop refractory disease
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