Obinutuzumab Outperforms Rituximab in Mantle Cell Lymphoma with Better MRD Clearance
The LyMa-101 trial with propensity score matching compared obinutuzumab versus rituximab in transplant-eligible mantle cell lymphoma patients. Obinutuzumab achieved higher bone marrow MRD negativity (83% vs 63%) and improved 5-year PFS (83% vs 67%) and OS (86% vs 71%). The results highlight measurable residual disease as a key laboratory endpoint that correlates with long-term clinical outcomes in lymphoma.
The original study
Obinutuzumab vs rituximab for transplant-eligible patients with mantle cell lymphoma.
- Authors
- Sarkozy C, Callanan M, Thieblemont C, Obéric L, Burroni B, Bouabdallah K, et al.
- Journal
- Blood
- Type
- Journal Article, Randomized Controlled Trial, Comparative Study, Multicenter Study, Research Support, Non-U.S. Gov't
- PMID
- 38669626
Original abstract
Obinutuzumab (O) and rituximab (R) are 2 CD antibodies that have never been compared in a prospective randomized trial of mantle cell lymphoma (MCL). Herein, we report the long-term outcome of the LyMa-101 trial, in which newly diagnosed patients with MCL were treated with chemotherapy plus O before transplantation, followed by O maintenance (O group). We then compared these patients with those treated with the same treatment design with R instead of O (R group). A propensity score matching (PSM) was used to compare the 2 populations (O vs R groups) in terms of measurable residual disease (MRD) at the end of induction (EOI), progression-free survival (PFS), and overall survival (OS). In LyMa-101, the estimated 5-year PFS and OS after inclusion (n = 85) were 83.4% (95% confidence interval [CI], 73.5-89.8) and 86.9% (95% CI, 77.6-92.5), respectively. At EOI, patients treated in the O group had more frequent bone marrow MRD negativity than those treated in the R group (83.1% vs 63.4%; χ2, P = .007). PSM resulted in 2 sets of 82 patients with comparable characteristics at inclusion. From treatment initiation, the O group had a longer estimated 5-year PFS (P = .029; 82.8% vs 66.6%; hazard ratio [HR], 1.99; 95% confidence interval (CI), 1.05-3.76) and OS (P = .039; 86.4% vs 71.4%; HR, 2.08; 95% CI, 1.01-4.16) compared with the R group. Causes of death were comparable in the 2 groups, the most common cause being lymphoma. O before transplantation and in maintenance provides better disease control and enhances PFS and OS compared with R in transplant-eligible patients with MCL. These trials were registered at www.clinicaltrials.gov as #NCT00921414 and NCT02896582.