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Lenalidomide/rituximab induces high molecular response in untreated follicular lymphoma: LYSA ancillary RELEVANCE study

Marie-Helene Delfau-Larue 1 Marie-Laure Boulland 2 Asma Beldi-Ferchiou 1 Pierre Feugier 3 Hervé Maisonneuve 4 Rene-Olivier Casasnovas 5 François Lemonnier 6 Gian Matteo Pica 7 Roch Houot 2 Loic Ysebaert 8 Hervé Tilly 9 Jean-Claude Eisenmann 10 Steven Le Gouill 11 Vincent Ribrag 12, 13 Pascal Godmer 14 Sylvie Glaisner 15 Guillaume Cartron 16, 17 Luc Xerri 18 Gilles André Salles 19 Thierry Fest 2 Franck Morschhauser 20 
Abstract : Abstract Complete molecular response (CMR) after first-line immunochemotherapy reflects treatment efficacy and may predict prognosis in patients with follicular lymphoma (FL). RELEVANCE is the first phase 3 trial comparing the chemotherapy-free regimen lenalidomide/rituximab (R2) vs rituximab/chemotherapy (R-Chemo) in previously untreated FL patients ( identifier: NCT01650701). The objective of the minimal residual disease (MRD) analysis was to determine the ability of a chemotherapy-free regimen to induce CMR. Of 440 French patients participating in the Lymphoma Study Association (LYSA) RELEVANCE MRD study, all 222 patients with a BIOMED-2–detectable BCL2-JH translocation at diagnosis were analyzed. MRD was quantified by droplet digital polymerase chain reaction with a sensitivity ≤10−4. At week 24 (end of induction treatment), 98% and 78% of patients achieved CMR in peripheral blood (PB) and bone marrow (BM), respectively. Achievement of CMR (in PB and/or BM) had a significant impact on progression-free survival (PFS), with 3-year PFS of 84% and 55% for patients with CMR and detectable MRD, respectively (P = .015). CMR at week 24 was reached more frequently in the R2 arm (105/117; 90%) than in the R-Chemo arm (70/90; 77%) (P = .022). The poor prognostic value in terms of PFS for the persistence of molecular disease was observed irrespective of treatment arm (interaction test, P = .31). In agreement with the clinical results of the RELEVANCE trial, our results show that R2 immunomodulatory treatment in first-line FL can achieve high rates of CMR.
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Submitted on : Tuesday, December 21, 2021 - 8:46:43 AM
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Marie-Helene Delfau-Larue, Marie-Laure Boulland, Asma Beldi-Ferchiou, Pierre Feugier, Hervé Maisonneuve, et al.. Lenalidomide/rituximab induces high molecular response in untreated follicular lymphoma: LYSA ancillary RELEVANCE study. Blood Advances, The American Society of Hematology, 2020, 4 (14), pp.3217-3223. ⟨10.1182/bloodadvances.2020001955⟩. ⟨inserm-03498367⟩



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