Dr. Flinn on the RELEVANCE Trial in Follicular Lymphoma

Ian Flinn, MD, PhD, director of the Blood Cancer Research Program, Sarah Cannon Research Institute, discusses the RELEVANCE trial in follicular lymphoma.

One of the key updates in follicular lymphoma, says Flinn, were the findings from the RELEVANCE trial. The phase III trial compared rituximab (Rituxan) and chemotherapy with rituximab and lenalidomide (Revlimid). The trial was based on phase II data that suggested that rituximab plus lenalidomide (R²) had very high complete remission (CR) rates and a tolerable safety profile.

At 120 weeks, the R² regimen showed a CR or unconfirmed CR rate of 48% compared with 53% for rituximab/chemotherapy (P = .13). The objective response rate was 84% and 89% for the R² regimen and rituximab/chemotherapy combination, respectively. The 3-year duration of response was 77% with R² compared with 74% for rituximab/chemotherapy.

Although the trial failed to meet its primary endpoint of R² superiority, response rates between the 2 arms were nearly identical, says Flinn. It also offers a non-chemotherapy approach for the frontline treatment of follicular lymphoma. This may be a valuable approach for patients who are looking to avoid the toxicities that are associated with rituximab/chemotherapy. Flinn notes that the toxicities were different between the 2 arms; there was a little bit more febrile neutropenia on the rituximab/chemotherapy arm and more rashes on the R² arm.