Maintenance Therapy
Maintenance therapy is the use of the monoclonal antibody Rituxan after remission is achieved. Recent American and Swiss studies indicate that maintenance therapy is a preemptive measure against residual disease and that it seems to delay or prevent relapse.
In the American study, Rituxan was given 4 times at 6 month intervals. In the Swiss study, Rituxan was given 1 time at 2 month intervals. In both, a significant number of patients stayed in remission longer than those who did not receive maintenance therapy, so there is little doubt that it is helpful.
What is not known is whether or not maintenance therapy causes resistance to Rituxan. Studies are underway to investigate this issue, and if results indicate that lymphoma cells become resistant to the drug, will it be more difficult to treat patients who relapse during maintenance or after? The question of whether it is better to prevent relapse or re-treat upon relapse remains unanswered.
Certainly Rituxan in invaluable. It has improved the outcome for many lymphoma patients. But there is also a psychological factor to maintenance therapy. I've conducted no scientific survey, but the patients I know who are continuing with therapy every few months don't consider themselves quite well, no matter how good they feel or how active they are.
I'm not aware of any study which compares radioimmunotherapy to maintenance therapy, but it would be interesting
to see the results. I would personally rather be treated with radioimmunotherapy and get on with my life without having periodic treatments, but patients should make individual choices.
Betsy