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Revlimid/Rituxan Highly Active as Initial Therapy for Mantle Cell Lymphoma

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The treatment combination consisting of Revlimid (lenalidomide) plus Rituxan (rituximab) provides high rates of long-lasting anti-cancer responses when used as initial therapy for mantle cell lymphoma. These results were recently published in the New England Journal of Medicine.

Mantle-cell lymphoma is a relatively rare type of cancer that starts in immune cells called B-cells. Often, this disease is diagnosed in patients 60 years or older and occurs more often in men.

Mantle-cell lymphoma (MCL) can be aggressive, particularly if found in its more advanced stages, or can act as a slow-growing cancer in its earlier stages.

Treatment for MCL varies considerably, depending upon how far the cancer has spread, its aggressiveness, previous therapy that has been received, and the overall health, age and other medical issues of the patient.

Rituximab is an agent that is commonly used in the treatment of MCL, and targets specific proteins that are expressed on the surface of B cell, called CD 20. Lenalidomide was approved in 2013 for the treatment of MCL that has already been treated with at least 2 prior therapies, but recurred.

Researchers recently conducted a clinical trial to further explore the effectiveness of rituximab plus lenalidomide as treatment for patients with MCL who had never received prior therapy. The trial included 38 patients and was conducted from 2011-2014 at 4 separate medical centers.

At a median of 30 months following completion of therapy, anti-cancer responses occurred in 92%, with a complete disappearance of detectable cancer in 64% of patients.
The median survival time without progression of cancer (progression-free survival) had not yet been reached.
Overall survival rate at two years was 97%.
At two years, progression-free survival was estimated to be 85%.
Patients who responded to treatment reported an improved quality of life.
The most common serious side effects included low blood cell levels and rash.
The researchers concluded that the treatment combination consisting of lenalidomide and rituximab provides high rates of anti-cancer activity for extended periods of time among patients with MCL who had not received prior treatment. Furthermore, patients who responded to therapy had an improved quality of life.

The authors stated that “Combination biologic therapy consisting of lenalidomide plus rituximab was active as initial therapy for mantle-cell lymphoma.”

Reference: Ruan J, Martin P, Shah B, et al. Lenalidomide plus rituximab as initial treatment for mantle-cell lymphoma. New England Journal of Medicine. 2015; 373:1835-1844.