349P - Overall survival and progression-free survival comparison of lenalidomide + standard therapy versus standard therapy only in indolent lymphoma: A meta-analysis

Background

Indolent lymphomas, a heterogeneous group of non-Hodgkin lymphomas, exhibit a slow-growing nature and pose distinct clinical challenges due to their potential for relapse and transformation. While standard therapies have demonstrated efficacy in controlling disease progression, efforts to enhance treatment outcomes have led to investigations into combination regimens. Lenalidomide, an immunomodulatory agent with antiangiogenic and antitumor properties, has shown promise in various hematological malignancies. This meta-analysis aim to assess the impact of adding lenalidomide to standard therapy on overall survival (OS) and progression-free survival (PFS) in patients with indolent lymphoma.

Methods

A comprehensive search strategy was employed to identify relevant studies from electronic databases (PubMed, Embase, Web of Science) up to August 2023. Inclusion criteria encompassed randomized controlled trials (RCTs) that compared lenalidomide + standard therapy versus standard therapy alone in patients with indolent lymphoma. Pooled hazard ratios (HRs) for OS and PFS were calculated using random-effects models. Heterogeneity of the pooled analysis was measured by the chi-squared test and I² statistic. All statistical analyses were conducted using RevMan software (version 5.4; Cochrane Collaboration, London, UK).

Results

The initial search yielded 573 articles, of which 4 randomized controlled trials (RCTs) met the eligibility criteria for inclusion in the meta-analysis. The combined data indicated that there was no statistically significant difference in OS (HR: 0.90; 95% CI: 0.59-1.38; p = 0.63; I² = 24%) and PFS (HR: 0.76; 95% CI: 0.50-1.50; p = 0.20; I² = 88%) between patients treated with lenalidomide + standard therapy and those receiving standard therapy alone for indolent lymphoma. Moreover, the use of lenalidomide was not significantly associated with neutropenia (OR: 2.76; 95% CI: 0.72-10.50; p = 0.14; I² = 95%).

Conclusions

Incorporation of lenalidomide into standard therapy does not yield benefits in both OS and PFS. Due to heterogeneity in PFS and neutropenia pooled analysis, further trials are needed to confirm the results.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.