The following is a summary of “Long-Term Follow-Up of the RESORT Study (E4402): A Randomized Phase III Comparison of Two Different Rituximab Dosing Strategies for Low–Tumor Burden Follicular Lymphoma,” published in the January 2024 issue of Oncology by Kahl, et al.

For a study, researchers sought to evaluate the long-term outcomes of two rituximab dosing strategies in patients with previously untreated low–tumor burden follicular lymphoma, focusing on secondary endpoints such as time to first cytotoxic therapy, duration of response, and overall survival (OS).

The Eastern Cooperative Oncology Group conducted a randomized phase III clinical trial (E4402) in 2003. The trial enrolled rituximab-responsive patients (n = 299) who were randomly assigned to receive either retreatment rituximab (RR) or maintenance rituximab (MR) until treatment failure. The primary endpoint was time to treatment failure (TTF).

At the 7-year follow-up, 83% of MR patients had not needed first chemotherapy, contrasting with 63% of RR patients (hazard ratio, 2.37 [95% CI, 1.5 to 3.76]). Additionally, 71% of MR patients remained in their first remission at 7 years, compared to 37% of RR patients. Despite the prolonged first remission observed with MR, there was no difference in OS at 10 years (83% vs. 84%).

The study confirmed that prolonged maintenance rituximab does not confer an OS advantage in low–tumor burden follicular lymphoma, as evidenced by mature long-term data. Despite the improved duration of the first remission with MR, the lack of difference in OS suggested careful consideration of rituximab dosing strategies in the patient population.

Reference: ascopubs.org/doi/10.1200/JCO.23.01912