Rituximab versus obinutuzumab-based first-line chemoimmunotherapy for follicular lymphoma—a real-world multicenter retrospective cohort study

Tamar Berger*, Tzippy Shochat, Shlomzion Aumann, Boaz Nachmias, Neta Goldschmidt, Nurit Horesh, Reut Harel, Ariel Aviv, Ella Shmerts, Uri Abadi, Shai Shimony, Pia Raanani, Anat Gafter‑Gvili, Ronit Gurion

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

The GALLIUM study showed a progression-free survival advantage of 7% in favor of obinutuzumab vs. rituximab-based immunochemotherapies as first-line therapy in follicular lymphoma (FL) patients. Yet, the toxicity appears to be increased with obinutuzumab-based therapy. This is a multicenter retrospective-cohort study including adult FL patients comparing the toxicity of first-line rituximab vs. obinutuzumab-based chemo-immunotherapies (R and O groups, respectively). We compared the best standard-of-care therapy used per time period, before and after obinutuzumab approval. The primary outcome was any infection during induction and 6 months post-induction. Secondary outcomes included rates of febrile neutropenia, severe and fatal infections, other adverse events, and all-cause mortality. Outcomes were compared between groups. A total of 156 patients were included in the analysis, 78 patients per group. Most patients received bendamustine (59%) or CHOP (31.4%) as adjacent chemotherapy. Half of the patients received growth-factor prophylaxis. Overall, 69 patients (44.2%) experienced infections, and a total of 106 infectious episodes were recorded. Patients in the R and O groups had similar rates of any infection (44.8% and 43.5%, p = 1), severe infections (43.3% vs. 47.8%, p = 0.844), febrile neutropenia (15% vs. 19.6%, p = 0.606), and treatment discontinuation, as well as similar types of infections. No covariate was associated with infection in multivariable analysis. No statistically significant difference was evident in adverse events of grades 3–5 (76.9% vs. 82%, p = 0.427). To conclude, in this largest real-life study of first-line treated FL patients comparing R- to O-based therapy, we did not observe any difference in toxicity during the induction and 6 months post-induction period.

Original languageEnglish
Pages (from-to)2127-2136
Number of pages10
JournalAnnals of Hematology
Volume102
Issue number8
DOIs
StatePublished - Aug 2023

Keywords

  • Chemo-immunotherapy
  • Follicular lymphoma (FL)
  • Induction
  • Obinutuzumab
  • Rituximab

Fingerprint

Dive into the research topics of 'Rituximab versus obinutuzumab-based first-line chemoimmunotherapy for follicular lymphoma—a real-world multicenter retrospective cohort study'. Together they form a unique fingerprint.

Cite this