Common brand names

• Gazyva

How it is administered

Obinutuzumab is administered as an intravenous (IV) infusion. It is supplied as a sterile, preservative-free liquid concentrate at a concentration of 25 mg/mL in single-dose vials. The medication is diluted and given through a vein by a healthcare professional in a clinic or hospital setting. It is not given as a quick injection (IV push or bolus), but rather as a slow infusion over several hours, especially for the first dose. The dosing schedule and infusion rates depend on the specific blood cancer being treated and the cycle of therapy.

How it works

Obinutuzumab is a type of monoclonal antibody that targets a protein called CD20, which is found on the surface of certain B cells (a type of white blood cell). By binding to CD20, obinutuzumab helps the immune system recognize and destroy these B cells, including those that are cancerous. It works through several mechanisms:

• It attracts immune cells to attack and kill the targeted B cells (antibody-dependent cellular cytotoxicity and phagocytosis).
• It can directly trigger cell death in the B cells.
• It can activate the complement system, another part of the immune response, to help destroy the B cells.

Obinutuzumab is engineered to have greater activity than some earlier anti-CD20 antibodies, leading to more effective depletion of B cells. This helps control blood cancers like chronic lymphocytic leukemia (CLL) and follicular lymphoma, and may be used in combination with other chemotherapy medicines.

Who should take it

Obinutuzumab is indicated for adults with certain types of blood cancers, specifically:

• In combination with chlorambucil for patients with previously untreated chronic lymphocytic leukemia (CLL).
• In combination with bendamustine, followed by obinutuzumab alone, for patients with follicular lymphoma who have relapsed after or are refractory to a rituximab-containing regimen.
• In combination with chemotherapy, followed by obinutuzumab alone for patients with previously untreated stage II bulky, III, or IV follicular lymphoma.

While obinutuzumab is not specifically approved for mantle cell lymphoma, it is used for other B-cell blood cancers. Patients should discuss with their doctor whether this medication is appropriate for their specific type of blood cancer.

Who should not take it

Obinutuzumab should not be used in patients who have had a known hypersensitivity reaction (such as anaphylaxis) to obinutuzumab or any of its ingredients, or who have experienced serum sickness with prior use of obinutuzumab.

It should not be given to patients with active infections. Caution is also advised in patients with a history of recurring or chronic infections, and in those with severe liver or kidney problems. Pregnant women should avoid this medication due to the risk of harm to the fetus, and women of childbearing potential should use effective contraception during treatment and for six months after the last dose.

Commonly used with

Obinutuzumab is commonly used in combination with other chemotherapy agents, such as:

• Chlorambucil (for chronic lymphocytic leukemia)
• Bendamustine (for follicular lymphoma)
• CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or CVP (cyclophosphamide, vincristine, and prednisone) regimens (for follicular lymphoma)

The choice of combination depends on the specific type of blood cancer being treated and the patient's overall health.

Commonly tested with

Obinutuzumab has been tested in clinical trials with several chemotherapy regimens, including:

• Chlorambucil
• Bendamustine
• CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)
• CVP (cyclophosphamide, vincristine, prednisone)

These combinations have been studied to determine their effectiveness and safety in treating different types of blood cancers, particularly chronic lymphocytic leukemia and follicular lymphoma.