Obinutuzumab and Early Progression of FL

An article in the journal Haematologica shows that Obinutuzumab + chemo does a better job than Rituxan + chemo of holding off POD24.

The article came out in December (I know, I'm behind of my reading), and is called "Association of Early Disease Progression and Very Poor Survival in the GALLIUM Study in Follicular Lymphoma: Benefit of Obinutuzumab in Reducing the Rate of Early Progression."

The article reports on more results from the GALLIUM study. It looks like this is an updated result from what had been reported at the 2017 ASH conference (which would have been about a year before this was published).

The GALLIUM study looked at untreated FL patients (1202 of them). All were given Immunochemotherapy, but half were given Rituxan + chemo, and the other half got Obinutuzumab + chemo.

One area of interest was POD24 -- Progression of Disease within 24 months. This has been a hot topic lately, and I've written about it a few times in the last few months.  Basically, FL patients who have had Immunochemotherapy, and then have their disease return within 24 months, have a lower Overall Survival rate.

This study found that patients in Obinutuzumab + chemo group had a much lower rate of POD24 than those in the Rituxan + chemo group -- about 46% lower (57 out of 601 patients in the O group, and 98 out of 601 in the R group).

The conclusion requires some speculation -- if patients who are POD24 have a lower Overall Survival, and O + chemo keeps patients out of the POD24 group, then maybe Obinutuzumab will help Overall Survival.

So far, that's a big Maybe. The study hasn't followed patients long enough to see if there's an Overall Survival benefit. But there certainly seems to be a POD24 benefit.

That big question is going to take a while to answer. And these early results don't mean that everyone should have O instead of R. (In fact, patients in the study who were not POD24 had a 98.2% Overall Survival rate at 2 years, while those who were POD had an 82.4% OS in that time. The non-POD24 group did just fine without O.)


If anything, the study confirms that the POD24 group needs special attention.

Has anyone out there had Obinutuzumab, either on its own, or as a combo? Curious to hear about your experiences. It's one of a few alternatives to Rituxan (some biosimilars being other alternatives), and I'd like to know how widespread it is. Thanks.