Maintenance rituximab in Veterans with follicular lymphoma
Abstract Real‐world practice patterns and clinical outcomes in patients with follicular lymphoma (FL), including the adoption of maintenance rituximab (MR) therapy in the United States (US), have been reported in few studies since the release of the National LymphoCare Study almost a decade ago. We...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-10-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.3420 |
| _version_ | 1828752398141620224 |
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| author | Ahmad S. Halwani Kelli M. Rasmussen Vikas Patil Deborah Morreall Catherine Li Christina Yong Zachary Burningham Keith Dawson Anthony Masaquel Kevin Henderson Elisha DeLong‐Sieg Brian C. Sauer |
| author_facet | Ahmad S. Halwani Kelli M. Rasmussen Vikas Patil Deborah Morreall Catherine Li Christina Yong Zachary Burningham Keith Dawson Anthony Masaquel Kevin Henderson Elisha DeLong‐Sieg Brian C. Sauer |
| author_sort | Ahmad S. Halwani |
| collection | DOAJ |
| description | Abstract Real‐world practice patterns and clinical outcomes in patients with follicular lymphoma (FL), including the adoption of maintenance rituximab (MR) therapy in the United States (US), have been reported in few studies since the release of the National LymphoCare Study almost a decade ago. We analyzed data from the largest integrated healthcare system in the United States, the Veterans Health Administration (VHA), to identify rates of adoption and effectiveness of MR in FL patients after first‐line (1L) treatment. We identified previously untreated patients with FL in the VHA between 2006 and 2014 who achieved at least stable disease after chemoimmunotherapy or immunotherapy. Among these patients, those who initiated MR within 238 days of 1L composed the MR group, whereas those who did not were classified as the non‐MR group. We examined the effect of MR on progression‐free survival (PFS) and overall survival (OS). A total of 676 patients met our inclusion criteria, of whom 300 received MR. MR was associated with significant PFS (hazard ratio [HR]=0.55, P < .001) and OS (HR = 0.53, P = .005) compared to the non‐MR group, after adjusting by age, sex, ethnicity, geographic region, diagnosis period, stage, grade at diagnosis, hemoglobin, lactate dehydrogenase (LDH), Charlson comorbidity index (CCI), 1L treatment regimen, and response to 1L treatment. These results suggest that in FL patients who do not experience disease progression after 1L treatment in real‐world settings, MR is associated with a significant improvement in both PFS and OS. Maintenance therapy should be considered in FL patients who successfully complete and respond to 1L therapy. |
| first_indexed | 2024-12-10T21:08:19Z |
| format | Article |
| id | doaj.art-8499b8c9b6b045c18a609fd2d80fd1a5 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-12-10T21:08:19Z |
| publishDate | 2020-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-8499b8c9b6b045c18a609fd2d80fd1a52022-12-22T01:33:33ZengWileyCancer Medicine2045-76342020-10-019207537754710.1002/cam4.3420Maintenance rituximab in Veterans with follicular lymphomaAhmad S. Halwani0Kelli M. Rasmussen1Vikas Patil2Deborah Morreall3Catherine Li4Christina Yong5Zachary Burningham6Keith Dawson7Anthony Masaquel8Kevin Henderson9Elisha DeLong‐Sieg10Brian C. Sauer11Division of Hematology and Hematologic Malignancies Huntsman Cancer Institute Salt Lake City Utah USADivision of Epidemiology VERITAS University of Utah Salt Lake City Utah USADivision of Epidemiology VERITAS University of Utah Salt Lake City Utah USADivision of Epidemiology VERITAS University of Utah Salt Lake City Utah USADivision of Epidemiology VERITAS University of Utah Salt Lake City Utah USADivision of Epidemiology VERITAS University of Utah Salt Lake City Utah USADivision of Epidemiology VERITAS University of Utah Salt Lake City Utah USAUS Medical Affairs Genentech Inc South San Francisco CA USAUS Medical Affairs Genentech Inc South San Francisco CA USAUS Medical Affairs Genentech Inc South San Francisco CA USAUS Medical Affairs Genentech Inc South San Francisco CA USADivision of Epidemiology VERITAS University of Utah Salt Lake City Utah USAAbstract Real‐world practice patterns and clinical outcomes in patients with follicular lymphoma (FL), including the adoption of maintenance rituximab (MR) therapy in the United States (US), have been reported in few studies since the release of the National LymphoCare Study almost a decade ago. We analyzed data from the largest integrated healthcare system in the United States, the Veterans Health Administration (VHA), to identify rates of adoption and effectiveness of MR in FL patients after first‐line (1L) treatment. We identified previously untreated patients with FL in the VHA between 2006 and 2014 who achieved at least stable disease after chemoimmunotherapy or immunotherapy. Among these patients, those who initiated MR within 238 days of 1L composed the MR group, whereas those who did not were classified as the non‐MR group. We examined the effect of MR on progression‐free survival (PFS) and overall survival (OS). A total of 676 patients met our inclusion criteria, of whom 300 received MR. MR was associated with significant PFS (hazard ratio [HR]=0.55, P < .001) and OS (HR = 0.53, P = .005) compared to the non‐MR group, after adjusting by age, sex, ethnicity, geographic region, diagnosis period, stage, grade at diagnosis, hemoglobin, lactate dehydrogenase (LDH), Charlson comorbidity index (CCI), 1L treatment regimen, and response to 1L treatment. These results suggest that in FL patients who do not experience disease progression after 1L treatment in real‐world settings, MR is associated with a significant improvement in both PFS and OS. Maintenance therapy should be considered in FL patients who successfully complete and respond to 1L therapy.https://doi.org/10.1002/cam4.3420clinical observationsepidemiologyhaematological cancerlymphoma |
| spellingShingle | Ahmad S. Halwani Kelli M. Rasmussen Vikas Patil Deborah Morreall Catherine Li Christina Yong Zachary Burningham Keith Dawson Anthony Masaquel Kevin Henderson Elisha DeLong‐Sieg Brian C. Sauer Maintenance rituximab in Veterans with follicular lymphoma Cancer Medicine clinical observations epidemiology haematological cancer lymphoma |
| title | Maintenance rituximab in Veterans with follicular lymphoma |
| title_full | Maintenance rituximab in Veterans with follicular lymphoma |
| title_fullStr | Maintenance rituximab in Veterans with follicular lymphoma |
| title_full_unstemmed | Maintenance rituximab in Veterans with follicular lymphoma |
| title_short | Maintenance rituximab in Veterans with follicular lymphoma |
| title_sort | maintenance rituximab in veterans with follicular lymphoma |
| topic | clinical observations epidemiology haematological cancer lymphoma |
| url | https://doi.org/10.1002/cam4.3420 |
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