{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T14:58:34Z","timestamp":1790521114635,"version":"4.1.0"},"reference-count":15,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"28","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2022,10,1]]},"abstract":"<jats:p> Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. <\/jats:p><jats:p> The RELEVANCE trial (ClinicalTrials.gov identifier: NCT01650701 ) showed that lenalidomide plus rituximab (R<jats:sup>2<\/jats:sup>) provided similar efficacy to rituximab plus chemotherapy (R-chemo) in patients with advanced-stage, previously untreated follicular lymphoma (FL). We report the second interim analysis of the RELEVANCE trial after 6 years of follow-up. Patients with previously untreated grade 1-3a FL were assigned 1:1 to R<jats:sup>2<\/jats:sup> or R-chemo, followed by rituximab maintenance. Coprimary end points were complete response (confirmed\/unconfirmed) at week 120 and progression-free survival (PFS). At median follow-up of 72 months, 6-year PFS was 60% and 59% for R<jats:sup>2<\/jats:sup> and R-chemo, respectively (hazard ratio = 1.03 [95% CI, 0.84 to 1.27]). Six-year overall survival was estimated to be 89% in both groups. Median PFS and overall survival were not reached in either group. Overall response after progression was 61% and 59%, and 5-year estimated survival rate after progression was 69% and 74% in the R<jats:sup>2<\/jats:sup> and R-chemo groups, respectively. The transformation rate per year in the R<jats:sup>2<\/jats:sup> and R-chemo groups was 0.68% and 0.45%, and secondary primary malignancies occurred in 11% and 13% ( P = .34), respectively. No new safety signals were observed. R<jats:sup>2<\/jats:sup> continues to demonstrate comparable, durable efficacy and safety versus R-chemo in previously untreated patients with FL and provides an acceptable chemo-free alternative. <\/jats:p>","DOI":"10.1200\/jco.22.00843","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T19:59:13Z","timestamp":1660161553000},"page":"3239-3245","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":67,"title":["Six-Year Results From RELEVANCE: Lenalidomide Plus Rituximab (R<sup>2<\/sup>) Versus Rituximab-Chemotherapy Followed by Rituximab Maintenance in Untreated Advanced Follicular Lymphoma"],"prefix":"10.1200","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3714-9824","authenticated-orcid":false,"given":"Franck","family":"Morschhauser","sequence":"first","affiliation":[{"name":"University of Lille, CHU Lille, Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6071-8610","authenticated-orcid":false,"given":"Loretta","family":"Nastoupil","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Feugier","sequence":"additional","affiliation":[{"name":"Nancy University Hospital, Vandoeuvre-l\u00e8s-Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9923-4808","authenticated-orcid":false,"given":"Jean-Marc","family":"Schiano de Colella","sequence":"additional","affiliation":[{"name":"Institut Paoli Calmettes, CRCM, AMU, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herv\u00e9","family":"Tilly","sequence":"additional","affiliation":[{"name":"Centre Henri Becquerel, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5099-9156","authenticated-orcid":false,"given":"Maria Lia","family":"Palomba","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2694-7510","authenticated-orcid":false,"given":"Emmanuel","family":"Bachy","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon and Claude Bernard Lyon 1 Universit\u00e9, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Fruchart","sequence":"additional","affiliation":[{"name":"CH de Dunkerque, Dunkerque, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward N.","family":"Libby","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1156-8983","authenticated-orcid":false,"given":"Rene-Olivier","family":"Casasnovas","sequence":"additional","affiliation":[{"name":"CHU Dijon-Bourgogne, Dijon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6724-290X","authenticated-orcid":false,"given":"Ian W.","family":"Flinn","sequence":"additional","affiliation":[{"name":"Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Haioun","sequence":"additional","affiliation":[{"name":"Henri Mondor Universit\u00e9 H\u00f4pital, UPEC, Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herv\u00e9","family":"Maisonneuve","sequence":"additional","affiliation":[{"name":"Centre Hospitalier D\u00e9partemental Vend\u00e9e, La Roche-sur-Yon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4102-7261","authenticated-orcid":false,"given":"Loic","family":"Ysebaert","sequence":"additional","affiliation":[{"name":"Institut Universitaire du Cancer Toulouse-Oncopole, Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8470-394X","authenticated-orcid":false,"given":"Nancy L.","family":"Bartlett","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine, St Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamal","family":"Bouabdallah","sequence":"additional","affiliation":[{"name":"Bordeaux University Hospital, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Brice","sequence":"additional","affiliation":[{"name":"H\u00f4pital Saint-Louis, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Ribrag","sequence":"additional","affiliation":[{"name":"Institut Gustave Roussy, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9840-2128","authenticated-orcid":false,"given":"Steven","family":"Le Gouill","sequence":"additional","affiliation":[{"name":"Institut Curie, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Daguindau","sequence":"additional","affiliation":[{"name":"Annecy H\u00f4pital, Annecy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Guidez","sequence":"additional","affiliation":[{"name":"CHU de Poitiers, Poitiers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Matteo","family":"Pica","sequence":"additional","affiliation":[{"name":"Centre Hospitalier M\u00e9tropole Savoie Chamb\u00e9ry, Chamb\u00e9ry, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6330-1028","authenticated-orcid":false,"given":"Alejandro Mart\u00edn","family":"Garc\u00eda-Sancho","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Salamanca, IBSAL, CIBERONC, Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8588-8381","authenticated-orcid":false,"given":"Armondo","family":"L\u00f3pez-Guillermo","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Larouche","sequence":"additional","affiliation":[{"name":"CHU de Qu\u00e9bec, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoshi","family":"Ando","sequence":"additional","affiliation":[{"name":"Tokai University School of Medicine, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6993-2450","authenticated-orcid":false,"given":"Maria","family":"Gomes da Silva","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas de Oncologia de Lisboa, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Andr\u00e9","sequence":"additional","affiliation":[{"name":"CHU UCL Namur, Yvoir, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6042-978X","authenticated-orcid":false,"given":"Wu","family":"Kalung","sequence":"additional","affiliation":[{"name":"ZNA Stuivenberg, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1860-9765","authenticated-orcid":false,"given":"Laurie H.","family":"Sehn","sequence":"additional","affiliation":[{"name":"BC Cancer Centre for Lymphoid Cancer, Vancouver, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9129-8057","authenticated-orcid":false,"given":"Koji","family":"Izutsu","sequence":"additional","affiliation":[{"name":"National Cancer Center Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0659-9635","authenticated-orcid":false,"given":"Guillaume","family":"Cartron","sequence":"additional","affiliation":[{"name":"CHU Montpellier, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Argyrios","family":"Gkasiamis","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Princeton, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell","family":"Crowe","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Princeton, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Xerri","sequence":"additional","affiliation":[{"name":"Institut Paoli Calmettes, CRCM, AMU, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan H.","family":"Fowler","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9541-8666","authenticated-orcid":false,"given":"Gilles","family":"Salles","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01234"},{"key":"b2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.00605"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.35.15_suppl.7501"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-10-3411"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.12.191"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.06.146"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.1038\/bcj.2015.66"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12708"},{"key":"b9","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2012.119"},{"key":"b10","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)70455-3"},{"key":"b11","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx496"},{"key":"b12","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-10-879643"},{"key":"b13","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1805104"},{"key":"b14","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.4.1244"},{"key":"b15","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-017-3151-2"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.22.00843","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T22:00:41Z","timestamp":1664402441000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.22.00843"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,1]]},"references-count":15,"journal-issue":{"issue":"28","published-print":{"date-parts":[[2022,10,1]]}},"alternative-id":["10.1200\/JCO.22.00843"],"URL":"https:\/\/doi.org\/10.1200\/jco.22.00843","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,1]]},"assertion":[{"value":"2022-04-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-01","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}