Understanding Your Treatment Options After Being Diagnosed with Advanced-Stage Follicular Lymphoma
If you are a person with advanced-stage follicular lymphoma who is starting their first treatment, learn how certain therapy options compare.
Choosing Your First Treatment with Advanced-Stage Follicular Lymphoma
The European Society for Medical Oncology (ESMO) guidelines recommend that advanced-stage follicular lymphoma patients receive chemotherapy in combination with a monoclonal antibody: obinutuzumab (Gazyva, Genentech) or rituximab (Rituxan, Genentech).
The question is: which chemotherapy regimen and which monoclonal antibody do you choose?
Please note that non-advanced stages of follicular lymphoma have different treatment recommendations. In some cases, these patients may not be treated and are simply observed. Click here to learn more.
R-CHOP vs. R-B for Follicular Lymphoma
Advanced-stage follicular lymphoma patients receiving treatment for the first time will usually have either R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) or R-B (rituximab and bendamustine). After the initial chemotherapy cycles are completed, patients will usually receive rituximab infusions over the next two years as a maintenance therapy.
In a clinical trial called the GELTAMO study, researchers evaluated if R-CHOP or R-B were more effective for advanced-stage follicular lymphoma patients.
Six years after patients started treatment, their findings showed:
-
79% of patients treated with R-B were still in remission
-
67% of patients treated with R-CHOP were still in remission
Rituximab vs. Obinutuzumab for Follicular Lymphoma
Monoclonal antibodies like rituximab and obinutuzumab treat follicular lymphoma by targeting a protein called CD20 on the surface of cancerous B cells. This marks the cancer cells for destruction by the immune system.
Does the monoclonal antibody you choose as part of your chemotherapy regimen matter?
The GALLIUM study found that follicular lymphoma patients treated for the first time had improved outcomes when they included obinutuzumab, rather than rituximab, in their chemotherapy regimens, followed by only the antibody as a two-year maintenance therapy.
After 7.9 years since the start of treatment:
-
63.4% of patients treated with obinutuzumab-based regimens remained in remission
-
55.7% of patients treated with rituximab-based regimens remained in remission
Patients on rituximab also needed to start their next cancer treatment sooner than those on obinutuzumab.
However, both monoclonal antibody groups showed no difference in overall survival, which measures the time patients lived after starting treatment.
Summary
Patients with advanced-stage follicular lymphoma who are beginning their first treatment have important choices to make, including selecting a chemotherapy regimen and a monoclonal antibody to accompany it.
The research shared here indicates that the R-B regimen, which combines rituximab and bendumustine, results in better long-term remission rates compared to R-CHOP.
Additionally, a study comparing the monoclonal antibodies obinutuzumab and rituximab for follicular lymphoma patients found that obinutuzumab outperforms rituximab when used in chemotherapy regimens followed by maintenance treatment with the antibody.
It is important to discuss treatment options with your doctor to ensure that you are receiving the best therapy for your personal situation.
Stay updated with the latest news on research and treatment of follicular lymphoma with HealthTree. Subscribe to our newsletter today!
Follicular Lymphoma Newsletter
Sources:
If you are a person with advanced-stage follicular lymphoma who is starting their first treatment, learn how certain therapy options compare.
Choosing Your First Treatment with Advanced-Stage Follicular Lymphoma
The European Society for Medical Oncology (ESMO) guidelines recommend that advanced-stage follicular lymphoma patients receive chemotherapy in combination with a monoclonal antibody: obinutuzumab (Gazyva, Genentech) or rituximab (Rituxan, Genentech).
The question is: which chemotherapy regimen and which monoclonal antibody do you choose?
Please note that non-advanced stages of follicular lymphoma have different treatment recommendations. In some cases, these patients may not be treated and are simply observed. Click here to learn more.
R-CHOP vs. R-B for Follicular Lymphoma
Advanced-stage follicular lymphoma patients receiving treatment for the first time will usually have either R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) or R-B (rituximab and bendamustine). After the initial chemotherapy cycles are completed, patients will usually receive rituximab infusions over the next two years as a maintenance therapy.
In a clinical trial called the GELTAMO study, researchers evaluated if R-CHOP or R-B were more effective for advanced-stage follicular lymphoma patients.
Six years after patients started treatment, their findings showed:
-
79% of patients treated with R-B were still in remission
-
67% of patients treated with R-CHOP were still in remission
Rituximab vs. Obinutuzumab for Follicular Lymphoma
Monoclonal antibodies like rituximab and obinutuzumab treat follicular lymphoma by targeting a protein called CD20 on the surface of cancerous B cells. This marks the cancer cells for destruction by the immune system.
Does the monoclonal antibody you choose as part of your chemotherapy regimen matter?
The GALLIUM study found that follicular lymphoma patients treated for the first time had improved outcomes when they included obinutuzumab, rather than rituximab, in their chemotherapy regimens, followed by only the antibody as a two-year maintenance therapy.
After 7.9 years since the start of treatment:
-
63.4% of patients treated with obinutuzumab-based regimens remained in remission
-
55.7% of patients treated with rituximab-based regimens remained in remission
Patients on rituximab also needed to start their next cancer treatment sooner than those on obinutuzumab.
However, both monoclonal antibody groups showed no difference in overall survival, which measures the time patients lived after starting treatment.
Summary
Patients with advanced-stage follicular lymphoma who are beginning their first treatment have important choices to make, including selecting a chemotherapy regimen and a monoclonal antibody to accompany it.
The research shared here indicates that the R-B regimen, which combines rituximab and bendumustine, results in better long-term remission rates compared to R-CHOP.
Additionally, a study comparing the monoclonal antibodies obinutuzumab and rituximab for follicular lymphoma patients found that obinutuzumab outperforms rituximab when used in chemotherapy regimens followed by maintenance treatment with the antibody.
It is important to discuss treatment options with your doctor to ensure that you are receiving the best therapy for your personal situation.
Stay updated with the latest news on research and treatment of follicular lymphoma with HealthTree. Subscribe to our newsletter today!
Follicular Lymphoma Newsletter
Sources:
about the author
Megan Heaps
Megan joined HealthTree in 2022. As a writer and the daughter of a blood cancer patient, she is dedicated to helping patients and their caregivers understand the various aspects of their disease. This understanding enables them to better advocate for themselves and improve their treatment outcomes. In her spare time, she enjoys spending time with her family.
More on Treatment Advances
Get the latest thought leadership on your Follicular lymphoma delivered straight to your inbox
Subscribe to the weekly newsletter for news, stories, clinical trial updates, and helpful resources and events with cancer experts.