R Maintenance

Good news this morning from the manufacturer of Rituxan: maintenance therapy with Rituxan cuts the chances of recurrance in half -- after two years, anyway.

According the article, Follicular NHL patients who had chemo and Rituxan, and who were then given Rituxan every six months after that, were twice as likely to be disease-free as those who didn't do the maintenance. According to the article ("Roche's Rituxan halves risk of lymphoma recurrence"), this was the case regardless of the patient's age, stage of disease, or any other factor.

The results came from a phase III clinical trial with a pretty significant number of subjects (1,000). As the article says, lots of people with NHL already use R maintenance; it's nice to get the results of a trial that will help this to become an officially FDA-approved practice.

Two things strike me as being worthy of caution: The title is a little misleading. The study measured progress over 2 years, so "halving the risk of recurrence" really doesn't tell the whole story. Lots of folks I know have had the disease return after 2 years of maintenance. So let's not get too crazy here -- we're not talking about a cure or anything.

The other thing that stands out for me still is the question of R maintenance for someone like me, who did not have chemo, but just Rituxan. There hasn't been any big trial for folks like us to determine if maintenance is useful. Dr. R and I had this conversation the last time we met. There isn't a lot of clinical evidence to determine whether or not continuing R maintenance for me would be useful. (Though there isn't any to say it won't be, either.)

Of course, I say there's never any guarantee of a treatment's success anyway, so why not go with the easiest, least toxic option anyway?

I see him a month or so. We'll fight it out then, I suppose....