Treatment strategies for nodal and gastrointestinal follicular lymphoma: Current status and future development

Table 4 Results of different randomized trials comparing no maintenance with maintenance therapy with rituximab or interferon after first line therapy in patients with follicular lymphoma

Author(s) or studies, maintenance therapy	No. of patients, target disease and randomization to therapies	Median age (yr)	Initial therapy,n (%)	CR rate	End point
					Median PFS	Median response duration	Overall survival
GLSG[43,46]	n = 105, relapsed or refractory FL					P = 0.035a
R-FCM	n = 52	59	R-FCM: 41 (79)		Not reached	32/41 (78%)
			FCM: 11 (21)
Observation	n = 53	61	R-FCM: 40 (75)		Not reached	21/40 (53%)
			FCM: 13 (25)
ECOG1496 study[47]	n = 311, stage III-IV indolent lymphoma (282 of 311 had FL)	61	CVP	P = 0.00006b		P = 0.012a	All: P = 0.05
							FL: P = 0.08 (trend towards significance)
R-CVP	n = 153		CVP	22%		All: 68% (at 3 yr)	All: 92% (at 3 yr)
						FL: 64% (at 3 yr)	FL: 91% (at 3 yr)
Observation	n = 158		CVP	7%		All: 33% (at 3 yr)	All: 86% (at 3 yr)
						FL: 33% (at 3 yr)	FL: 86% (at 3 yr)

^aP < 0.05,

^bP < 0.01, statistically significant. CR: Complete response; PFS: Progression-free survival; FL: Follicular lymphoma; GLSG: German Low-Grade Lymphoma Study Group; (R-)FCM: (Rituximab plus) fludarabine, cyclophosphamide, mitoxantrone; ECOG: Eastern Cooperative Oncology Group; (R-)CVP: (Rituximab plus) cyclophosphamide, vincristine, and prednisone.