Obinutuzumab vs Rituximab for Patients With Lymphoma
In the first installment of this 3-part video series, Jonathon Cohen, MD, MS, Assistant Professor, Lymphoma Group, Winship Cancer Institute at Emory University, Atlanta, Georgia, provides insight on whether obinutuzumab or rituximab is a more appropriate treatment option for patients with lymphoma at the 2018 Lymphoma & Myeloma congress.
Transcript
This morning I participated in a debate with Dr. Smith from the University of Chicago to look at the most appropriate anti-CD20 antibody to use in the management of patients with lymphoma. Primarily we focused on obinutuzumab or rituximab which has been the standard of care for quite some years.
My position was that obinutuzumab is a superior antibody. It's important to note though that this is more of a nuanced discussion.
There are considerable studies and data that would suggest that patients with indolent non-Hodgkin lymphoma may benefit from receiving obinutuzumab instead of rituximab. There's both the frontline GALLIUM study as well as the GADOLIN study that took place in replaced indolent lymphoma that would suggest that obinutuzumab does provide benefit over rituximab.
One of the points that came up in this debate was that there doesn't appear to be an overall survival benefit especially in the frontline setting. One of our arguments however, today, was that there is prolonged, progression-free survival. We do know that in follicular lymphoma especially, having an early relapse after frontline treatment is particularly associated with inferior survival.
In large-cell lymphoma, the story is a little bit less clear. We discussed the GOYA study which suggested that there is no benefit of obinutuzumab over rituximab.
I pointed out to the group today that it is difficult to interpret studies of large-cell lymphoma given the challenges sometimes with accruing some of the highest risk patients due to the rapid progression of disease, and the fact that many of them don't qualify for study.
As a result, I would argue that patients who have indolent lymphoma should be considered for obinutuzumab. Its role in aggressive lymphomas has yet to be determined.
