Obinutuzumab-Based Regimens in the First-Line Therapy for Follicular Lymphoma: Data from Real-World Clinical Practice in 41 Medical Institutions
DOI:
https://doi.org/10.21320/2500-2139-2026-19-4-363-374AIM. To assess the efficacy and safety of combined obinutuzumab-based regimens in the first-line therapy for follicular lymphoma (FL) in real-world clinical practice.
MATERIALS & METHODS. This retrospective multicenter study enrolled 279 newly diagnosed FL patients treated with obinutuzumab in combination with chemotherapy at 41 medical institutions in Russia from 2018 to 2026. The median age of patients was 49.2 years (range 30–83 years), 60.6 % of them were women. Obinutuzumab-based regimens were predominantly administered to patients with stage III/IV (86.4 %), advanced tumor spread (60.2 %), and often with intraabdominal location (76.3 %). More than 1/3 of patients had extranodal lesions (41.9 %) and bulky tumors (34.8 %). According to FLIPI score, there were 74.9 % of patients with intermediate and poor prognosis. More than half of the patients (54.4 %) received anthracycline-based G-CHOP regimen as initial therapy, GB was administered to 30.1 % of patients. Maintenance therapy with obinutuzumab was used in 72.8 % of cases.
RESULTS. Overall response to therapy was achieved in 95.6 % of patients, the rate of complete metabolic response was 91.1 %. Adverse events of any grade were observed in 51.8 % of patients, grade ≥ 3 was identified in 29 % (primarily neutropenia and infectious complications). With the median follow-up of 16.3 months, disease progression or relapse were diagnosed in 21 (7.5 %) patients, histological transformation into diffuse large B-cell lymphoma was reported after 6 out of 14 biopsies performed at the stage of FL relapse. The 2-year progression-free survival was 89.6 %, and the 2-year overall survival was 98 %.
CONCLUSION. The results of this study confirm high efficacy of obinutuzumab in the first-line therapy for FL patients with prognostically unfavorable characteristics of tumor. Overall and complete metabolic response rates are consistent with the international data. The administration of obinutuzumab-based regimens provide significant therapeutic control of the disease and confirm the reproducibility of the data from clinical studies in real-world healthcare practice.
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