Dr. Hilal on the Benefit of Maintenance Rituximab in Patients With MCL

Talal Hilal, MB, BCh, assistant professor of Medicine at Mayo Clinic, discusses the benefit of maintenance rituximab (Rituxan) in the treatment of patients with mantle cell lymphoma (MCL).

A subgroup analysis of the StiL NHL7-2008 MAINTAIN trial presented at the 2016 ASCO Annual Meeting looked at bendamustine/rituximab induction followed by maintenance therapy compared with observation. However, no benefit in progression-free survival or overall survival were observed with the maintenance therapy. Notably, these were patients who had not received a transplant or were unfit for transplant. Based off of these data, most physicians will not offer maintenance rituximab in this setting; instead, they’ll offer chemoimmunotherapy to patients.

Investigating rituximab maintenance with a more intensive chemotherapy regimen may prove useful in this setting, says Hilal. Additionally, using cytarabine induction in patients who are younger may be beneficial; this population may benefit from maintenance rituximab. As it stands, maintenance rituximab is advised for patients after transplant, whereas it remains investigational in those who have not undergone transplant, concludes Hilal.