R-Squared for Follicular Lymphoma

The New England Journal of Medicine today published "Rituximab plus Lenalidomide in Advanced Untreated Follicular Lymphoma." This is the official peer-reviewed publication of the research on R-Squared that was presented at ASCO in June.

That's significant. When research is presented at a conference, it's usually in a big room full of other researchers. They can ask questions, have discussions, etc. But it's all still kind of unofficial.

When the research is published in a peer-reviewed medical journal, it's worth taking more seriously. "Peer-reviewed"means that, before it is published, it is given to some other experts, who can look at it more deeply and make sure that the data that was collected is actually doing what the researchers say it is doing. 

So the research about R-Squared is now "official." 

R-Squared, in case you're new to all of this, is a combination of Rituxan and Revlimid (also known as Lenalidomide). This combination is significant, because neither of the two agents is traditional chemotherapy. If the combo is effective, it is a big step forward in one day eliminating chemotherapy. Instead, we'd rely on treatments that target cancer cells and not healthy cells (like chemo can do), causing, in theory, fewer side effects.

The results of the study show that the R-Squared combo is about as effective as chemo (R-CHOP, R-CVP, or R-Bendamustine). Both also received Rituxan Maintenance.

The numbers don't seem to have changed from the ASCO presentation, so you can read more detail from my post from May.

As I said in a post a few days after that, the authors of the study seemed to be very cautious in how significant this is. They do the same thing here. They are both effective options, and they both have side effects, though those side effects are different.

As I'm writing this, I'm starting to see a few medical sites publishing stories about it, and most seem to be pushing the idea that R-Squared is as effective as the R+chemo is was compared to. 

That's good. The question now is, what comes next? Since this comes from a phase 3 trial, we can assume that the combination will be put up for approval by the FDA and other regulatory bodies at some point, and the numbers suggest it will do pretty well. 

From there, it will be up to oncologists to recommend it to patients, as an alternative to chemo, as a first treatment. If enough do that, it could really change the way FL is treated. 

Time will tell. For now, it's more waiting an seeing. But definitely something to be hopeful about.