In a placebo-controlled trial in about 300 patients who were most often in good general health and were being treated with rituximab, addition of lenalidomide extended progression-free survival and possibly reduced mortality, at a cost of an increase in serious adverse effects. However, for most of the patients included in the trial, rituximab alone has not been shown to be the optimal treatment, hence the results are biased in favour of lenalidomide. In practice, the combination of lenalidomide + rituximab has not been shown to represent an advance in comparison to other combinations of cancer drugs.
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