What is the role for maintenance lenalidomide in elderly patients with DLBCL?

The REMARC study was a phase III trial of maintenance with lenalidomide versus placebo in patients aged 60-80 years old who were in a PR or CR after RCHOP for newly diagnosed DLBCL (Thieblemont et al. JCO 35:2471-2481, 2017.). The results of this large study (650pts) with a median follow up of over 3 years were a statistical improvement in median PFS in the lanalidomide arm (median not reached vs. 58.9 months, p=0.01). Interestingly, there was no statistical difference in the percentage of patients converting from PR to CR in the placebo versus the lenalidomide arms. There was no difference in overall survival with a median follow up of 52 months ([p=0.26).

There are several issues that need to be taken into account when considering mainten...