Reducing Early Disease Progression in Follicular Lymphoma - Episode 2

The GALLIUM Study: Four-Year Results

Timothy Fenske, MD, MS:The GALLIUM study was a large prospective randomized trial of patients with previously untreated follicular lymphoma. The study aimed to look at the question of which antibody is the optimal antibody to pair with chemotherapy for these patients. Centers were allowed to choose 1 of 3 chemotherapy regimens: bendamustine, CHOP [cyclophosphamide, hydroxydaunorubicin, oncovin, prednisone], or CVP [cyclophosphamide, vincristine, prednisone]. The 2 arms were either rituximab with chemotherapy followed by rituximab maintenance, or obinutuzumab with chemotherapy followed by obinutuzumab maintenance.

In the most recent update to the GALLIUM trial, the obinutuzumab chemotherapy arm continued to have an improved progression-free survival at 78%, progression-free at 4 years, versus 67% in the rituximab-chemotherapy arm.

I think these results are significant because progression-free survival is an important endpoint in follicular lymphoma. In particular, having patients remain progression-free for the first 2 years after treatment has been shown repeatedly to be an important predictor of subsequent survival. I think anything that we can offer our patients that might improve their progression-free survival, particularly in the first year or 2, is important because that has an impact on their overall survival.

I think that this is particularly important in younger patients because these are patients who are more likely to have their life span affected by their lymphoma. If someone who is in their 80s or 90s, follicular lymphoma is unlikely to define their life expectancy. However, if we have somebody who’s in their 40s or 50s, there’s a good chance that the lymphoma could become a life-threatening process for them. I think anything that keeps them out of that early progressor group is important to consider for that patient.

Transcript edited for clarity.