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CompletedNCT01650701RELEVANCEUpdated Sep 25, 2025

A Phase 3 Open Label Randomized Study to Compare the Efficacy and Safety of Rituximab Plus Lenalidomide (CC-5013) Versus Rituximab Plus Chemotherapy Followed by Rituximab in Subjects With Previously Untreated Follicular Lymphoma

A Phase 3 interventional study of Rituximab and Lenalidomide in Follicular Lymphoma, sponsored by The Lymphoma Academic Research Organisation. Completed at 35 sites in 8 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-09-25.

Sponsored by The Lymphoma Academic Research Organisation · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Registered 5 months after the study started (first participant enrolled Feb 2012, registered Jul 2012).
Phase
Phase 3
Study type
Interventional
Enrollment
1,030
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to find out if lenalidomide when given along with rituximab can help to control the disease and also increase the length of your response (complete or partial response) compared to the standard of care rituximab chemotherapy treatment.

Read the detailed description

Follicular Lymphoma (FL) is a cancer of a B lymphocyte, a type of white blood cell. FL is typically a slowly progressing but incurable disease. Follicular lymphoma cells produce a specific defect in the patient's immune system impairing their ability to control their cancer. Lenalidomide has been shown to reverse the specific immune defect caused by FL in the patient. By including lenalidomide, the RELEVANCE study aims to eliminate the cancer while restoring the patient's immune competence.

02

Conditions studied

  • Follicular Lymphoma

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Keywords

  • follicular lymphoma
  • non-hodgkins follicular lymphoma
  • treatment for follicular lymphoma
  • rituximab treatment
  • rituximab and lenalidomide treatment
03

In context

Lymphoma, Follicular

931 studies on the registry are indexed under Lymphoma, Follicular; 237 are open to participants now.

This study's enrollment of 1,030 is above the median of 48 across 797 interventional studies indexed under Lymphoma, Follicular.

Browse Lymphoma, Follicular studies →

Lead sponsor

The Lymphoma Academic Research Organisation is the lead sponsor of 60 studies on the registry; 12 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Histologically confirmed CD20+ follicular lymphoma grade 1, 2 or 3a
  • Have no prior systemic treatment for lymphoma.
  • Must be in need of treatment
  • Bi-dimensionally measurable disease with at least one mass lesion > 2 cm that was not previously irradiated.
  • Stage II, III or IV disease.
  • Must be ≥ 18 years and sign an informed consent.
  • Performance status ≤ 2 on the ECOG scale.
  • Adequate hematological function (unless abnormalities are related to lymphoma infiltration of the bone marrow)
  • Willing to follow pregnancy precautions

Exclusion criteria

Exclusion Criteria:

  • Clinical evidence of transformed lymphoma by investigator assessment or Grade 3b follicular lymphoma.
  • Patients taking corticosteroids during the last 4 weeks, unless administered at a dose equivalent to \< 10 mg/day prednisone (over these 4 weeks).
  • Major surgery (excluding lymph node biopsy) within 28 days prior to signing informed consent.
  • Known Seropositive for or active viral infection with hepatitis B virus (HBV), hepatitis C virus (HCV)or human immunodeficiency virus (HIV).
  • Life expectancy \< 6 months.
  • Known sensitivity or allergy to murine products.
  • Prior history of malignancies, other than follicular lymphoma, unless the patient has been free of the disease for ≥ 10 years.
  • Prior use of lenalidomide.
  • Neuropathy > Grade 1.
  • Presence or history of CNS involvement by lymphoma.
  • Patients who are at a high risk for a thromboembolic event and are not willing to take venous thromboembolic (VTE) prophylaxis.
  • serum aspartate transaminase (AST/SGOT) or alanine transaminase (ALT/SGPT) > 3x upper limit of normal (ULN), except in patients with documented liver or pancreatic involvement by lymphoma
  • total bilirubin > 2.0 mg/dl (34 µmol/L) except in cases of Gilberts Syndrome and documented liver involvement by lymphoma
  • creatinine clearance of \< 30 mL/min
  • Pregnant or lactating females.
  • Any condition, including the presence of laboratory abnormalities, which places the patient at unacceptable risk if he/she were to participate in the study, or which confounds the ability to interpret data from the study.
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
1,030 participants (actual)

Study arms

  • Experimental
    Lenalidomide + Rituximab

    * Lenalidomide dose 20-mg on days 2-22 every 28 days x 6 cycles, if CR then 10-mg on days 2-22 every 28 days for 12 cycles. PR after 6 cycles, continue 20 mg for 3\~6 cycles and then 10 mg on days 2-22 every 28-day cycles for upto 18 cycles * Rituximab, 375 mg/m2 on days 1, 8, 15 and 22 of cycle 1, day 1 of cycles 2 to 6; 8 weeks later responding patients continue with 375 mg/m2 rituximab every 8 weeks for 12 cycles.

    Drug: Rituximab · Drug: Lenalidomide

  • Active comparator
    Control

    • ONE of the following: Rituximab - CHOP, Rituximab - CVP, Rituximab - Bendamustine. 7 to 8 weeks later responding patients will continue with 375 mg/m2 rituximab every 8 weeks for 12 cycles.

    Drug: Rituximab - CHOP · Drug: Rituximab - CVP · Drug: Rituximab - Bendamustine

Interventions

  • DrugRituximab

    • Rituximab, 375 mg/m2 on days 1, 8, 15 and 22 of cycle 1, day 1 of cycles 2 to 6; 8 weeks later responding patients continue with 375 mg/m2 rituximab every 8 weeks for 12 cycles.

    Also known as: mabthera, rituxan

  • DrugLenalidomide

    • Lenalidomide dose 20-mg on days 2-22 every 28 days x 6 cycles, if CR then 10-mg on days 2-22 every 28 days for 12 cycles. PR after 6 cycles, continue 20 mg for 3\~6 cycles and then 10 mg on days 2-22 every 28-day cycles for upto 18 cycles

    Also known as: Revlimid

  • DrugRituximab - CHOP

    six cycles of R-CHOP in 21 day cycles followed by two 21 day cycles of 375 mg/m2 rituximab; and 7 weeks later responding patients continue with 375 mg/m2 rituximab every 8 weeks for 12 cycles

  • DrugRituximab - CVP

    eight cycles of R-CVP in 21 day cycles; and 7 weeks later responding patients continue with 375 mg/m2 rituximab every 8 weeks for 12 cycles,

  • DrugRituximab - Bendamustine

    six cycles of R-B in 28 day cycles and 8 weeks later responding patients continue with 375 mg/m2 rituximab every 8 weeks for 12 cycles.

06

What researchers measure

Primary outcomes

  1. COMPLETE RESPONSE RATE

    Complete response (CR/CRu) rate at 120 weeks Response evaluation was as defined by International Working Group (IWG) Response Criteria (Cheson 1999). Complete response (CR) is defined as the complete disappearance of all detectable clinical and radiographic evidence of disease and the disappearance of all disease-related symptoms if present before therapy.

    Time frame: Timeframe: CR/CRu rate at 120 weeks

  2. Progression Free Survival (PFS)

    PFS is defined as the time from the start of study drug therapy to the 1st observation of disease progression or death due to any cause.

    Time frame: up to 13 years

Secondary outcomes

  1. Number of participants with adverse events

    Time frame: up to13 years

  2. Time to Treatment Failure (TTF)

    Time frame: up to13 years

  3. Event Free Survival (EFS)

    Time frame: up to13 years

  4. Time to Next Anti-Lymphoma Treatment (TTNLT),

    Time frame: up to13 years

  5. Time to Next Chemotherapy Treatment (TTNCT)

    Time frame: up to13 years

  6. Overall Survival (OS)

    Time frame: up to13 years

  7. Overall response rate at 120 weeks by International Working Group (IWG) 1999 criteria

    Time frame: up to13 years

  8. Health related quality of life as measured by the EORTC QLQ-C30

    Time frame: up to13 years

07

Study locations

35 sites
  • Concord Repatriation General Hospital
    Concord, New South Wales, Australia
  • Nepean Hospital
    Penrith, New South Wales, Australia
  • Wollongong Hospital
    Wollongong, New South Wales, Australia
  • CHU Mont-Godinne
    Yvoir, Belgium
  • Tom Baker Cancer Centre
    Calgary, Alberta, Canada
  • Cross Cancer Institute
    Edmonton, Alberta, Canada
  • Fraser Valley Cancer Centre
    Surrey, British Columbia, Canada
  • BCCA - Vancouver Cancer Centre
    Vancouver, British Columbia, Canada
  • Moncton Hospital
    Moncton, New Brunswick, Canada
  • Atlantic Health Sciences Corp - Saint John Regional Hospital
    Halifax, Nova Scotia, Canada
  • Sunnybrook Health Sciences Centre
    Toronto, Ontario, Canada
  • UHN-Princess Margaret Hospital
    Toronto, Ontario, Canada
  • CHUM Hopital Notre-Dame
    Montreal, Quebec, Canada
  • McGill University Department of Oncology
    Montreal, Quebec, Canada
  • Hôpital de l'Enfant-Jesus, CHU de Quebec
    Québec, Quebec, Canada
  • Saskatoon Cancer Centre
    Saskatoon, Saskatchewan, Canada
  • CHU Claude Huriez
    Lille, France
  • Medizinische Klinik der Universität Tübingen
    Tübingen, Baden-Wurttemberg, Germany
  • Uniklinik Köln
    Cologne, Nordrhein, Germany
  • LMU Munchën - Klinikum Grosshadern
    München, Germany
  • Sant'Andrea Hospital
    Rome, Lazio, Italy
  • Policlinico Sant'Orsola-Malpighi
    Bologna, Italy
  • Instituto Português Oncologia
    Lisbon, Portugal
  • Hospital Virgen del Rocio
    Seville, Andaloucia, Spain
  • Hospital Universitario Mutua de Terrassa
    Terrassa, Barcelona, Spain
  • Hospital Universitario de Canarias
    Santa Cruz de Tenerife, Canary Islands, Spain
  • Hospital Son Llatzer
    Palma, Mallorca, Spain
  • Hospital Clínico de Barcelona
    Barcelona, Spain
  • Hospital de la Santa Creu i Sant Pau
    Barcelona, Spain
  • Hospital Universitario Vall d´Hebron
    Barcelona, Spain
  • Institut Català d'Oncologia de Girona (ICO Girona)
    Girona, Spain
  • Hospital Ramon y Cajal
    Madrid, Spain
  • Hospital Costa del Sol
    Marbella, Spain
  • Hospital Universitario Salamanca
    Salamanca, Spain
  • Hospital Clínico Universitario de Valencia
    Valencia, Spain
08

References and documents

Publications

  • Gower N, Feugier P, Westin J, Schiano De Colella JM, Tilly H, Palomba ML, Julia E, Damaj GL, Durand A, Flinn I, Lemonnier F, Morineau N, Ysebaert L, Bartlett N, Thieblemont C, Ribrag V, Gastinne T, Dony A, Fouillet L, Guidez S, Houot R, Da Silva MG, Barnes J, Bijou F, Cartron G, Garcia-Sancho AM, Eradat H, Cheminant M, Guillermo AL, Abrisqueta P, Abraham J, Sarkozy C, Izutsu K, Crochet G, Sehn LH, Gkasiamis A, Yge ML, Chartier L, Fowler N, Xerri L, Salles G, Morschhauser F. Lenalidomide plus rituximab for previously untreated advanced follicular lymphoma: the 10-year RELEVANCE trial analysis. Blood. 2026 Jun 18;147(25):3061-3068. doi: 10.1182/blood.2026033126. PubMed 41915772 ↗
  • Claudel A, Cottereau AS, Bachy E, Itti E, Feugier P, Rossi C, Lemonnier F, Camus V, Daguindau N, Cartron G, Nicolas-Virelizier E, Mboumba DL, Cardoso C, Bommier C, Tessoulin B, Fruchart C, Gilbert A, Durot E, Fleck E, Pica GM, Zerazhi H, Guidez S, Cheminant M, Sarkozy C, Xerri L, Vercellino L, Trabelsi N, Gomes L, Portugues C, Viailly PJ, Delfau-Larue MH, Morschhauser F. Combined PET and ctDNA response as a predictor of POD24 for follicular lymphoma after first-line induction treatment. Blood. 2025 Aug 21;146(8):913-925. doi: 10.1182/blood.2024027727. PubMed 40499012 ↗
  • Laurent C, Trisal P, Tesson B, Seth S, Beyou A, Roulland S, Lesne B, Van Acker N, Cerapio JP, Chartier L, Guille A, Stokes ME, Huang CC, Huet S, Gandhi AK, Morschhauser F, Xerri L. Follicular lymphoma comprises germinal center-like and memory-like molecular subtypes with prognostic significance. Blood. 2024 Dec 12;144(24):2503-2516. doi: 10.1182/blood.2024024496. PubMed 39374535 ↗
  • Morschhauser F, Nastoupil L, Feugier P, Schiano de Colella JM, Tilly H, Palomba ML, Bachy E, Fruchart C, Libby EN, Casasnovas RO, Flinn IW, Haioun C, Maisonneuve H, Ysebaert L, Bartlett NL, Bouabdallah K, Brice P, Ribrag V, Le Gouill S, Daguindau N, Guidez S, Pica GM, Garcia-Sancho AM, Lopez-Guillermo A, Larouche JF, Ando K, Gomes da Silva M, Andre M, Kalung W, Sehn LH, Izutsu K, Cartron G, Gkasiamis A, Crowe R, Xerri L, Fowler NH, Salles G. Six-Year Results From RELEVANCE: Lenalidomide Plus Rituximab (R2) Versus Rituximab-Chemotherapy Followed by Rituximab Maintenance in Untreated Advanced Follicular Lymphoma. J Clin Oncol. 2022 Oct 1;40(28):3239-3245. doi: 10.1200/JCO.22.00843. Epub 2022 Aug 10. PubMed 35947804 ↗
  • Delfau-Larue MH, Boulland ML, Beldi-Ferchiou A, Feugier P, Maisonneuve H, Casasnovas RO, Lemonnier F, Pica GM, Houot R, Ysebaert L, Tilly H, Eisenmann JC, Le Gouill S, Ribrag V, Godmer P, Glaisner S, Cartron G, Xerri L, Salles GA, Fest T, Morschhauser F. Lenalidomide/rituximab induces high molecular response in untreated follicular lymphoma: LYSA ancillary RELEVANCE study. Blood Adv. 2020 Aug 11;4(14):3217-3223. doi: 10.1182/bloodadvances.2020001955. PubMed 32673385 ↗
  • Morschhauser F, Fowler NH, Feugier P, Bouabdallah R, Tilly H, Palomba ML, Fruchart C, Libby EN, Casasnovas RO, Flinn IW, Haioun C, Maisonneuve H, Ysebaert L, Bartlett NL, Bouabdallah K, Brice P, Ribrag V, Daguindau N, Le Gouill S, Pica GM, Martin Garcia-Sancho A, Lopez-Guillermo A, Larouche JF, Ando K, Gomes da Silva M, Andre M, Zachee P, Sehn LH, Tobinai K, Cartron G, Liu D, Wang J, Xerri L, Salles GA; RELEVANCE Trial Investigators. Rituximab plus Lenalidomide in Advanced Untreated Follicular Lymphoma. N Engl J Med. 2018 Sep 6;379(10):934-947. doi: 10.1056/NEJMoa1805104. PubMed 30184451 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 25, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT01650701
Lead sponsor
The Lymphoma Academic Research Organisation
Collaborators
Celgene Corporation
Responsible party
Sponsor
First posted
Jul 26, 2012
Start date
Feb 2012
Primary completion
May 31, 2017
Completion
Apr 30, 2024
Last update
Sep 25, 2025

Study contacts

Franck Morschhauser, MD, PhD
study chair · The Lymphoma Study Association (LYSA)

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Sep 2025. You cannot join it, but the record below documents what was studied.

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