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. 2023 May;149(5):1883-1893.
doi: 10.1007/s00432-022-04155-2. Epub 2022 Jul 5.

Comparative analysis of rituximab or obinutuzumab combined with CHOP in first-line treatment of follicular lymphoma

Gwladys Claustre  1 , Coralie Boulanger  2 , Frédéric Maloisel  3 , Nelly Etienne-Selloum  4   5 , Luc-Matthieu Fornecker  6 , Eric Durot  7 , Florian Slimano  2   8 , Véronique Graff  9
Affiliations

Comparative analysis of rituximab or obinutuzumab combined with CHOP in first-line treatment of follicular lymphoma

Gwladys Claustre et al. J Cancer Res Clin Oncol. 2023 May.

Abstract

Purpose: Rituximab (R) or obinutuzumab (G) combined with CHOP chemotherapy are used in previously untreated follicular lymphoma (FL). The aim is to compare in real life setting the efficacy and safety of these therapeutic strategies and assess the economic impact of introducing G.

Methods: This retrospective study, performed in 3 centers, included data from all patients who received R-CHOP or G-CHOP for previous untreated FL from June 1st, 2016 to December 31st, 2020. Progression-Free Survival (PFS) were estimated according to the Kaplan-Meier method. A budgetary impact model was performed from the French health care system's perspective.

Results: N = 124 patients were included (58 G-CHOP; 66 R-CHOP). Fifty-one and 57 patients achieved a complete response at the end of induction in the G-CHOP and R-CHOP group, respectively. PFS was not significantly longer in the G-CHOP group (HR 0.28; 95% CI 0.08-0.97; p value = 0.14). Hematological toxicity occurred more frequently with G-CHOP than R-CHOP during induction treatment (n = 58; 100% vs. n = 61; 92%), including higher severe neutropenia (grade ≥ 3) (n = 26; 45% vs. n = 23; 35%). Infusion-related reactions during the first infusion occurred more frequently with G-CHOP (n = 19; 33% vs. n = 16; 24%). The introduction of a completed G treatment (induction and maintenance) results in an additional cumulative cost per patient estimated at more than €30,000.

Conclusion: Similar results were found in the GALLIUM subgroup analysis study, suggesting that at this time there is no absolute benefit to administer G-CHOP instead of R-CHOP in all patients with previously untreated FL and may encourage clinical and economic trials including quality of life data.

Keywords: Drug therapy; Follicular lymphoma; Obinutuzumab; Rituximab.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Kaplan-Meier PFS estimation
See this image and copyright information in PMC

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