Deciding on Rituximab Versus Obinutuzumab in Follicular Lymphoma

John M. Burke, MD, associate chair of the Hematology Research Program for US Oncology and medical oncologist and hematologist at Rocky Mountain Cancer Centers, discusses treatment with rituximab (Rituxan) versus obinutuzumab (Gazyva) in patients with advanced stage follicular lymphoma with high tumor burden.

Burke says that generally, for this patient population, most physicians will treat them with chemoimmunotherapy, but there are differences among practice for whether they will choose rituximab or obinutuzumab for immunotherapy and bendamustine (Bendeka), cisplatin, or CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) for chemotherapy.

In practice, Burke usually uses obinutuzumab because of the data from the GALLIUM trial (NCT01332968). This study showed obinutuzumab had a longer progression-free survival than rituximab for patients with previously untreated advanced stage follicular lymphoma when both were combined with chemotherapy. He says although that’s his personal choice, it is a less common choice than rituximab in this setting because there’s no known survival advantage with obinutuzumab over rituximab, and there’s some added toxicity with obinutuzumab for this patient population. There are physicians who have been using rituximab longer and are more comfortable with it and have decided to continue using it in their practice.

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