# FORTplus

Source: https://onco.cc/trials/fortplus/  
OnCo record `fortplus` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A trial testing whether a radiotherapy dose one sixth of the standard works as well for early follicular lymphoma when an antibody is given alongside it.

## Summary

Two pieces of evidence pull in opposite directions here. The FoRT trial found 4 Gy of radiotherapy inferior to 24 Gy for indolent lymphoma on response and progression-free survival. The MIR study and TROG 99.03 found that adding an anti-CD20 antibody to localised radiotherapy improves outcomes, and the GAZAI study reported a high complete response rate with 2 by 2 Gy combined with obinutuzumab.

FORTplus tests whether the antibody makes the low dose safe. Its first question is the non-inferiority of 4 Gy given with an anti-CD20 antibody; if that holds, its second is whether obinutuzumab with low-dose radiotherapy is superior to rituximab with the standard dose, tested on the same set. The primary endpoint is morphological complete response, with primary completion estimated for 30 September 2027 at German sites.

The prize the trial is playing for is explicit in its protocol: a radiation dose reduced to 16 per cent of the standard, which would change how early follicular lymphoma is treated everywhere, including in settings where radiotherapy capacity is the binding constraint.

## Fields

- Kind: Trial
- Status: active
- Last checked: 2026-10-01
- Also known as: FORTplus trial; Early Stage Follicular Lymphoma and Radiotherapy plus Anti-CD20 Antibody
- Tags: lymphoma-evidence
- Registry id: NCT05045664
- Phase: 3
- Setting: Early-stage follicular lymphoma: low-dose radiotherapy of 4 Gy with an anti-CD20 antibody against standard-dose radiotherapy with rituximab, and obinutuzumab against rituximab
- Sponsor: Heidelberg University
- Enrolled: 100

## Sources

- ClinicalTrials.gov NCT05045664: https://clinicaltrials.gov/study/NCT05045664
- FoRT long-term follow-up, Lancet Oncology 2021: https://doi.org/10.1016/S1470-2045(20)30686-0

## Connected records

- cancers: [Follicular lymphoma](https://onco.cc/cancers/follicular-lymphoma/), [Non-Hodgkin lymphoma (all types)](https://onco.cc/cancers/non-hodgkin-lymphoma/)
- fronts: [Immunotherapy](https://onco.cc/fronts/immunotherapy/), [Radiation Therapy](https://onco.cc/fronts/radiation/)
- terms: [Complete response](https://onco.cc/terms/complete-response/), [Non-inferiority trial](https://onco.cc/terms/non-inferiority/), [Radiotherapy](https://onco.cc/terms/radiotherapy/)
- technologies: [Monoclonal antibodies](https://onco.cc/technologies/monoclonal-antibody/)
- targets: [CD20](https://onco.cc/targets/cd20/)
- drugs: [Obinutuzumab](https://onco.cc/drugs/obinutuzumab/), [Rituximab](https://onco.cc/drugs/rituximab/)
- trials: [GALLIUM](https://onco.cc/trials/gallium/), [TROG 99.03](https://onco.cc/trials/trog-99-03/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Surgery and radiotherapy cure most, get least](https://onco.cc/bottlenecks/b-surgery-radiation-innovation/), [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)
- key papers: [FoRT long-term follow-up: 4 Gy versus 24 Gy for follicular and marginal zone lymphoma](https://onco.cc/key-papers/paper-fort-long-term-follow-up-hoskin-lancet-oncol-2021/), [FoRT: 4 Gy versus 24 Gy radiotherapy for indolent lymphoma, a randomised phase 3 non-inferiority trial](https://onco.cc/key-papers/paper-fort-4gy-vs-24gy-indolent-lymphoma-hoskin-lancet-oncol-2014/), [Randomized trial of systemic therapy after involved-field radiotherapy in patients with early-stage follicular lymphoma: TROG 99.03](https://onco.cc/key-papers/paper-trog-99-03-radiotherapy-systemic-therapy-early-follicular-jco-2018/)
- roadmaps: [Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting](https://onco.cc/roadmaps/lymphoma-roadmap/)

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