{"entity":{"id":"paper-goya-obinutuzumab-vs-rituximab-chop-dlbcl-jco-2017","kind":"paper","name":"Obinutuzumab or rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone in previously untreated diffuse large B-cell lymphoma","aka":["GOYA","Vitolo 2017"],"tldr":"A newer antibody against the same target did not improve first-line treatment of the commonest aggressive lymphoma, although it had improved treatment of two other B-cell cancers.","summary":"A randomised phase 3 trial in which 1,418 patients with previously untreated advanced diffuse large B-cell lymphoma received eight 21-day cycles of obinutuzumab (706) or rituximab (712) with six or eight cycles of CHOP. The primary endpoint was investigator-assessed progression-free survival.\n\nAfter a median observation of 29 months there were 201 progression-free survival events (28.5 per cent) with obinutuzumab and 215 (30.2 per cent) with rituximab, a stratified hazard ratio of 0.92 (95 per cent confidence interval 0.76 to 1.11, p = 0.39), with three-year rates of 70 and 67 per cent. Independently reviewed progression-free survival, other time-to-event endpoints and response rates were similar. Grade 3 to 5 adverse events occurred in 73.7 against 64.7 per cent, serious adverse events in 42.6 against 37.6 per cent and fatal adverse events in 5.8 against 4.3 per cent. In exploratory analysis, patients with germinal-centre B-cell subtype disease had better progression-free survival than those with activated B-cell subtype disease irrespective of treatment.","asOf":"2026-10-01","links":[{"label":"Journal of Clinical Oncology 2017","url":"https://doi.org/10.1200/JCO.2017.73.3402"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/28796588/"},{"label":"Europe PMC","url":"https://europepmc.org/article/MED/28796588"}],"tags":["lymphoma-evidence"],"related":["lymphoma-roadmap"],"cancers":["dlbcl","non-hodgkin-lymphoma"],"sections":["immunotherapy","chemotherapy"],"technologies":[],"targets":["cd20"],"drugs":["obinutuzumab","rituximab","cyclophosphamide","doxorubicin","vincristine","prednisone"],"companies":["roche-genentech"],"institutions":[],"pathways":[],"terms":["r-chop","cell-of-origin"],"trials":["goya","gallium"],"people":["laurie-sehn"],"bottlenecks":["b-negative-results","b-biomarker-validation"],"keyPapers":[],"journals":["jco"],"dependsOn":[],"notes":[],"journal":"Journal of Clinical Oncology","year":2017,"doi":"10.1200/JCO.2017.73.3402","pmid":"28796588","authors":"Vitolo U, Trněný M, Belada D, et al.","paperType":"rct","findings":["Obinutuzumab with CHOP did not improve progression-free survival over rituximab with CHOP (stratified hazard ratio 0.92, 95 per cent confidence interval 0.76 to 1.11, p = 0.39).","Three-year progression-free survival was 70 per cent with obinutuzumab and 67 per cent with rituximab.","Grade 3 to 5 adverse events occurred in 73.7 per cent with obinutuzumab against 64.7 per cent with rituximab; fatal adverse events in 5.8 against 4.3 per cent.","Infusion-related reactions occurred in 36.1 per cent with obinutuzumab against 23.5 per cent with rituximab.","In exploratory subgroup analysis, germinal-centre B-cell subtype disease had better progression-free survival than activated B-cell subtype disease irrespective of treatment."],"whatItMeans":"Rituximab remains the CD20 antibody used in first-line diffuse large B-cell lymphoma. The result is a warning against assuming an antibody improvement carries from one B-cell malignancy to another: the same substitution improved progression-free survival in chronic lymphocytic leukaemia and in follicular lymphoma.","caveats":["Median observation of 29 months is short for a disease in which most relapses occur within two years but survival differences take longer to emerge.","The cell-of-origin subgroup analysis was exploratory and described prognosis, not a treatment interaction.","The registry lists the study as terminated, reflecting the end of the development programme rather than a safety stop."],"changedPractice":false,"participants":1418},"route":"/key-papers/paper-goya-obinutuzumab-vs-rituximab-chop-dlbcl-jco-2017/","neighbours":{"roadmap":[{"id":"lymphoma-roadmap","kind":"roadmap","name":"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","route":"/roadmaps/lymphoma-roadmap/"}],"cancer":[{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"}],"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"},{"id":"immunotherapy","kind":"section","name":"Immunotherapy","route":"/fronts/immunotherapy/"}],"target":[{"id":"cd20","kind":"target","name":"CD20","route":"/targets/cd20/"}],"drug":[{"id":"cyclophosphamide","kind":"drug","name":"Cyclophosphamide","route":"/drugs/cyclophosphamide/"},{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"},{"id":"obinutuzumab","kind":"drug","name":"Obinutuzumab","route":"/drugs/obinutuzumab/"},{"id":"prednisone","kind":"drug","name":"Prednisone","route":"/drugs/prednisone/"},{"id":"rituximab","kind":"drug","name":"Rituximab","route":"/drugs/rituximab/"},{"id":"vincristine","kind":"drug","name":"Vincristine","route":"/drugs/vincristine/"}],"company":[{"id":"roche-genentech","kind":"company","name":"Roche / Genentech","route":"/companies/roche-genentech/"}],"term":[{"id":"cell-of-origin","kind":"term","name":"Cell of origin (GCB vs ABC)","route":"/terms/cell-of-origin/"},{"id":"r-chop","kind":"term","name":"R-CHOP (lymphoma chemoimmunotherapy)","route":"/terms/r-chop/"}],"trial":[{"id":"gallium","kind":"trial","name":"GALLIUM","route":"/trials/gallium/"},{"id":"goya","kind":"trial","name":"GOYA","route":"/trials/goya/"}],"person":[{"id":"laurie-sehn","kind":"person","name":"Laurie H. Sehn","route":"/people/laurie-sehn/"}],"bottleneck":[{"id":"b-biomarker-validation","kind":"bottleneck","name":"Biomarkers are not validated or standardised","route":"/bottlenecks/b-biomarker-validation/"},{"id":"b-negative-results","kind":"bottleneck","name":"Failures are hidden","route":"/bottlenecks/b-negative-results/"}],"journal":[{"id":"jco","kind":"journal","name":"Journal of Clinical Oncology","route":"/journals/jco/"}]}}