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Evolent Level 1 Medical Oncology

Pathways and Low-Value Regimens

Follicular Lymphoma / Marginal Zone Lymphomas (Non-Hodgkin Lymphoma)

Regimen Options
Last Updated: 11/18/2024 See Details

NOTE: FOR RITUXIMAB, THE USE OF A BIOSIMILAR OR THE REFERENCE PRODUCT IS ON PATHWAY

 

 

Evolent Pathways Febrile Neutropenic Risk Emetogenic Risk References

 Primary or Initial Therapy

R-CVP (rituximab, cyclophosphamide, vincristine, prednisone)

 

Low Moderate
 

R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone)

Intermediate High
 

bendamustine and rituximab (BR)

Intermediate Moderate
 

rituximab

Low Low

Maintenance (Consolidation or extended dosing)

rituximab *maintenance up to 2 years*

Low Low

Subsequent Therapy

rituximab 

Low Low
 

R-CVP (cyclophosphamide, vincristine, prednisone)

 

Low Moderate
 

R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone)

Intermediate High
 

bendamustine and rituximab (BR)

Intermediate Moderate
 

Best Supportive Care or Clinical Trial

Not Applicable Not applicable

 Primary or Initial Therapy

Evolent Pathways

R-CVP (rituximab, cyclophosphamide, vincristine, prednisone)

 

Febrile Neutropenic Risk
low
Emetogenic Risk
moderate
Evolent Pathways

R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone)

Febrile Neutropenic Risk
intermediate
Emetogenic Risk
high
Evolent Pathways

bendamustine and rituximab (BR)

Febrile Neutropenic Risk
intermediate
Emetogenic Risk
moderate
Evolent Pathways

rituximab

Febrile Neutropenic Risk
low
Emetogenic Risk
low

Maintenance (Consolidation or extended dosing)

Evolent Pathways

rituximab *maintenance up to 2 years*

Febrile Neutropenic Risk
low
Emetogenic Risk
low

Subsequent Therapy

Evolent Pathways

R-CVP (cyclophosphamide, vincristine, prednisone)

 

Febrile Neutropenic Risk
low
Emetogenic Risk
moderate
Evolent Pathways

R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone)

Febrile Neutropenic Risk
intermediate
Emetogenic Risk
high
Evolent Pathways

bendamustine and rituximab (BR)

Febrile Neutropenic Risk
intermediate
Emetogenic Risk
moderate
Evolent Pathways

Best Supportive Care or Clinical Trial

Febrile Neutropenic Risk
na
Emetogenic Risk
na
Regimen Alternative References
LOW VALUE REGIMENS (NON-PATHWAY) WITH SUPERIOR ALTERNATIVES

Initial therapy

** lenalidomide and rituximab ** applies to marginal zone lymphoma 

Alternative: (CVP + R) cyclophosphamide + vincristine + prednisone + rituximab 

LOW VALUE REGIMENS (NON-PATHWAY) WITH SUPERIOR ALTERNATIVES

Initial therapy

Regimen

** lenalidomide and rituximab ** applies to marginal zone lymphoma