Comparing obinutuzumab and rituximab in first-line chemotherapy regimens for follicular lymphoma

This study investigated the safety and effectiveness of obinutuzumab (Gazyva) versus rituximab (Rituxan) plus chemotherapy for previously untreated follicular lymphoma. This study concluded that obinutuzumab improved survival outcomes compared to rituximab.

Follicular lymphoma is the most common type of non-Hodgkin’s lymphoma. The current standard first-line treatment is rituximab plus chemotherapy. Typical regimens include CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone), CVP (CHOP without doxorubicin), and bendamustine (Treanda).

Previous research has shown that obinutuzumab led to better patient outcomes compared to rituximab when combined with chemotherapy. The impact of CHOP, CVP, or bendamustine on the safety and effectiveness of these treatments is under investigation.

This study involved 1,202 patients with previously untreated follicular lymphoma. Patients received obinutuzumab (50%) or rituximab (50%) plus chemotherapy. Chemotherapy regimens included CHOP, CVP, or bendamustine. The average follow-up period was 41.1 months.

Three-year progression-free survival (time from treatment until disease progression) was significantly higher for the obinutuzumab group (82%) compared to the rituximab group (75%). 

Three-year overall survival was slightly higher for the obinutuzumab group (94%) compared to the rituximab group (92%). 

Overall, 100% (G; obinutuzumab) and 98% (R; rituximab) of patients had side effects. 75% (G) versus 69% (R) reported severe, life-threatening, or fatal side effects. 45% (G) and 38% (R) reported low white blood cell count (neutropenia). 7% (G) and 5% (R) reported neutropenia with fever. 7% (G) and 4% (R) reported drug infusion-related reactions. 5% of patients in both groups reported pneumonia.

CHOP and CVP were associated with more side effects in the obinutuzumab group. Bendamustine was also associated with more infections in both groups compared to other regimens.

This study concluded that obinutuzumab improved survival outcomes more than rituximab in all three chemotherapy regimens.

Chemotherapy regimens were not randomly assigned to patients in this study. This makes it difficult to directly compare the results of the different regimens.