# GALLIUM: obinutuzumab for the first-line treatment of follicular lymphoma

Source: https://onco.cc/key-papers/paper-gallium-obinutuzumab-first-line-follicular-lymphoma-marcus-nejm-2017/  
OnCo record `paper-gallium-obinutuzumab-first-line-follicular-lymphoma-marcus-nejm-2017` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Obinutuzumab with chemotherapy and as maintenance kept follicular lymphoma from progressing for longer than rituximab, at the cost of more serious side effects.

## Summary

Open-label phase 3 trial: 1,202 patients with previously untreated follicular lymphoma were randomised to obinutuzumab or rituximab with bendamustine, CHOP or CVP, followed by antibody maintenance.

At a planned interim analysis after a median follow-up of 34.5 months, estimated three-year progression-free survival was 80.0 percent with obinutuzumab against 73.3 percent with rituximab (hazard ratio 0.66). Response rates were similar (88.5 against 86.9 percent); grade 3 to 5 adverse events (74.6 against 67.8 percent) and serious adverse events (46.1 against 39.9 percent) were more frequent with obinutuzumab, and infusion-related events were the most common adverse event.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Journal: New England Journal of Medicine
- Year: 2017
- DOI: 10.1056/NEJMoa1614598
- Authors: Marcus R, Davies A, Ando K, et al.
- Findings: Three-year progression-free survival 80.0 versus 73.3 percent; hazard ratio 0.66 (95% CI 0.51 to 0.85), p 0.001.; Overall response 88.5 versus 86.9 percent.; Grade 3 to 5 adverse events 74.6 versus 67.8 percent; deaths from adverse events 4.0 versus 3.4 percent.
- What it means: Obinutuzumab-based immunochemotherapy is a first-line option for follicular lymphoma; the choice against rituximab weighs longer progression-free survival against toxicity and cost.
- Caveats: No overall survival difference; toxicity was highest with bendamustine partners.; Open-label design with investigator-assessed primary endpoint, supported by independent review.

## Sources

- N Engl J Med 2017: https://doi.org/10.1056/NEJMoa1614598
- PubMed: https://pubmed.ncbi.nlm.nih.gov/28976863/

## Connected records

- cancers: [Follicular lymphoma](https://onco.cc/cancers/follicular-lymphoma/)
- drugs: [Obinutuzumab](https://onco.cc/drugs/obinutuzumab/), [Rituximab](https://onco.cc/drugs/rituximab/)
- trials: [GALLIUM](https://onco.cc/trials/gallium/)
- journals: [New England Journal of Medicine](https://onco.cc/journals/nejm/)

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