ArticleFrontiers in immunology2026
Obinutuzumab versus rituximab-based chemotherapy in high-tumor burden indolent B-cell lymphoma: a real-world comparative study.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Patients with previously untreated follicular lymphoma (FL) or marginal zone lymphoma (MZL) with high-tumor burden represent a subset with unfavorable prognosis. However, the efficacy of obinutuzumab in this specific high-risk population remains incompletely characterized. This study aimed to compare the efficacy and safety of obinutuzumab-based versus rituximab-based chemotherapy in patients with high-risk features of FL and MZL. Methods: A retrospective analysis was conducted on 186 patients with histologically confirmed FL or MZL who received either obinutuzumab-based (n=92) or rituximab-based (n=94) chemotherapy at the First Hospital of Jilin University from February 2016 to February 2025. A propensity score overlap weight (PSOW) analysis was performed to adjust statistical influences between the two groups. Efficacy evaluation included complete response rate (CRR), objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and progression of disease within 24 months (POD24). Results: After induction therapy, the CRR was significantly higher in the obinutuzumab group compared to the rituximab group (82.6% vs. 54.3%, p=0.014). With a median follow-up of 31.5 months, the obinutuzumab group demonstrated superior 3-year PFS (81.4% vs. 62.1%, p=0.0026) and 3-year OS (99.0% vs. 87.3%, p=0.004). The incidence of POD24 was lower in the obinutuzumab group (13.0% vs. 24.5%, p=0.046). Multivariable analysis identified rituximab-based treatment as an independent risk factor for inferior OS (HR 9.6, p=0.026). Safety profiles were similar between the two groups, with no significant differences in adverse event rates. Conclusion: Obinutuzumab-based chemotherapy was associated with significantly higher CRR, improved survival outcomes, and a lower POD24 rate compared to rituximab-based chemotherapy in patients with high-tumor burden of FL and MZL. These findings support the preferential use of obinutuzumab in this high-risk population.
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