Zucca E, et al. - Among untreated follicular lymphoma patients in need of systemic therapy, researchers compared the activity of rituximab vs rituximab plus lenalidomide in the SAKK 35/10 phase 2 trial. In a random manner, rituximab (375 mg/m2 IV on day 1, weeks 1-4, repeated week 12-15 in responding patients) or rituximab (same schedule) in combination with lenalidomide (15 mg PO daily for 18 weeks) was administered to patients; 77 patients were allocated to each. At 6 months, the combination arm had a significantly higher complete response (CR/CRu) rate, corroborated by an independent response review of only CT scans. Overall, significantly improved CR/CRu rates, progression-free survival, and time to next treatment were achieved with rituximab plus lenalidomide. This combination therapy was associated with higher but predictable and manageable toxicity. Both treatment arms had excellent overall survival.