Promising Results Treating Relapsed and Refractory Follicular Lymphoma with Zanubrutinib & Obinutuzumab

A non-chemo treatment combination of zanubrutinib (Brukinsa) and obinutuzumab (Gazyva) evaluated in the ROSEWOOD study showed promising results for helping many follicular lymphoma patients whose disease had come back after remission or the cancer cells had stopped responding to treatment achieve a reduction of cancer signs and symptoms. Read more about the study’s findings below. 

What are Zanubrutinib and Obinutuzumab?

Zanubrutinib is a non-chemo targeted therapy administered orally that helps kill follicular lymphoma cells. It works by blocking a molecule (Bruton’s tyrosine kinase [BTK]) on the surface of the cancer cell which plays a role in telling the cell to stay alive and keep making new cells. By blocking the BTK receptor, the cancerous B-cell dies. Zanubrutinib is currently available for the treatment of follicular lymphoma patients in clinical trials.

Obinutuzumab is a type of medicine called a monoclonal anti-CD20 antibody. It is administered by infusion and binds to protein CD20 on the surface of B-cells. Binding to the CD20 protein helps kill the follicular lymphoma cells. Obinutuzumab is currently FDA-approved for the treatment of follicular lymphoma. 

The ROSEWOOD Study 

The ROSEWOOD study investigated whether adding zanubrutinib in combination with obinutuzumab could create a more effective treatment outcome for relapsed and refractory follicular lymphoma patients compared to treating the cancer with obinutuzumab alone. 

217 relapsed/refractory follicular lymphoma patients from 17 different countries were split 2 to 1 into the treatment groups. Two-thirds of the patients received zanubrutinib with obinutuzumab. The remaining one-third received obinutuzumab by itself. The therapies were administered over the course of two years. 

Treatment outcomes 

• Zanubrutinib and obinutuzumab group: 
  • After 20 months of treatment, 69% of the patients achieved a reduction of cancer signs and symptoms (39% complete reduction, 30% partial reduction) 
  • Cancer cells did not progress for an average of 28 months from the start of treatment
• Obinutuzumab group:
  • After 20 months of treatment, 46% of the patients achieved a reduction of cancer signs and symptoms (19% complete reduction, 27% partial reduction)
  • At an average of 10.4 months from the start of therapy, the cancer cells stopped responding to treatment and began progressing again. Patients needed to switch to a different line of therapy at an average of 12.2 months from the start of treatment to manage the cancer

Manageable Side Effects 

The most common side effects of the zanubrutinib and obinutuzumab combination included low platelet count (thrombocytopenia), pneumonia, and diarrhea. Patients worked with their healthcare team to help reduce these side effects. 

Key Takeaways  

The findings of the ROSEWOOD study offer promising treatment results of a new non-chemo targeted therapy combination for relapsed and refractory follicular lymphoma patients. We are grateful for the doctors and patients who participate in cancer research to help accelerate cures and improve the quality of life for those living with blood cancer. 

Want to help accelerate a cure for follicular lymphoma? Get involved in research to support the next best treatment options for patients! 

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