Jeremy Abramson, MD, Clinical Director of the Center for Lymphoma at Massachusetts General Hospital, Boston, agrees that obinutuzumab is an advance over rituximab.

Like rituximab, obinutuzumab targets CD-20, but rituximab does not directly induce cell death. Obinutuzumab is a type 2 antibody and does cause direct cell death, so it has the potential to be a better “mouse trap,” he commented.

“Response rates were similar in the two arms, but progression-free survival was remarkably improved with the addition of obinutuzumab, almost doubled from 15 months to 30 months,” he said.

“This is the first study to show the benefit of obinutuzumab or any additional monoclonal antibody in the treatment of rituximab-refractory disease. This study could be practice-changing, with the caveat that results apply to patients with refractory disease who did not get bendamustine upfront as part of treatment. The study is practice-changing for patients with relapsed/rituximab-refractory indolent non-Hodgkin lymphoma who have never had bendamustine, but the truth is that bendamustine/rituximab has moved into upfront therapy in the United States in the past 2 years, and those patients were not studied in this ­trial,” Dr. Abramson commented. ■

Disclosure: Dr. Abramson reported no potential conflicts of interest.