In case you did not have the opportunity to review the recent paper by Morschhauser, Fowler, and coauthors in the September 6 issue of the New England Journal of Medicine, I will summarize it here. The RELEVANCE trial compared the R2 regimen (the novel combination of rituximab and lenalidomide) against R-chemo for frontline follicular lymphoma. Eligible patients had previously untreated, high–tumor burden follicular lymphoma. Lenalidomide was given at a dose of 20 mg/day for the first 21 of 28 days for 6 months, and then at 10?mg/day for 12 months. Rituximab was given throughout the 18 months of lenalidomide treatment, plus for an additional 12 months (total duration of treatment, 30 months). For the R-chemo control arm, individual treating physicians could choose CHOP, CVP, or bendamustine as their chemotherapy backbone, which was administered for 6 cycles, followed by 2 years of maintenance rituximab. The trial was designed to show superiority of the R2 regimen over R-chemo, and the co–primary endpoints were complete response rate at 120 weeks and progression-free survival.
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