Obinutuzumab

Obinutuzumab is a monoclonal antibody medication that targets CD20, a protein found on certain immune cells called B cells. It is being studied in clinical trials for treating several conditions, including different types of lymphoma, leukemia, and autoimmune disorders. This article summarizes key information about ongoing clinical trials investigating the use of obinutuzumab for various medical conditions.

Table of Contents

What is Obinutuzumab?

Obinutuzumab is a medication used to treat certain types of blood cancers. It is known by several names, including Gazyva, Gazyvaro, GA101, and RO5072759[1][2]. Obinutuzumab is a type of drug called a monoclonal antibody, which means it’s a laboratory-made protein designed to target specific cells in the body[3].

How Obinutuzumab Works

Obinutuzumab works by targeting a specific protein called CD20, which is found on the surface of certain white blood cells called B cells. In many blood cancers, these B cells grow out of control. By attaching to the CD20 protein, Obinutuzumab helps the body’s immune system recognize and destroy these cancerous B cells[3].

Obinutuzumab is considered a “type II anti-CD20 antibody,” which means it has been engineered to be more effective at destroying cancer cells compared to older medications that target CD20[4].

Conditions Treated with Obinutuzumab

Obinutuzumab is used to treat several types of blood cancers and related conditions, including:

  • Chronic Lymphocytic Leukemia (CLL): A slow-growing cancer of the blood and bone marrow[2]
  • Follicular Lymphoma (FL): A type of non-Hodgkin lymphoma that affects B cells[2]
  • Diffuse Large B-cell Lymphoma (DLBCL): An aggressive type of non-Hodgkin lymphoma[2]
  • Marginal Zone Lymphoma (MZL): A slow-growing type of non-Hodgkin lymphoma[4]
  • Mantle Cell Lymphoma: A rare type of non-Hodgkin lymphoma[5]
  • Post-transplant Lymphoproliferative Disorder (PTLD): A type of lymphoma that can occur after organ or stem cell transplantation[3]

Researchers are also studying Obinutuzumab for use in certain kidney conditions, such as membranous nephropathy and fibrillary glomerulonephritis[6][7].

How Obinutuzumab is Administered

Obinutuzumab is given as an intravenous (IV) infusion, which means it’s delivered directly into a vein. The typical dose is 1000 mg, but the schedule can vary depending on the condition being treated and other factors[1].

For example, a common schedule for the first treatment cycle might be:

  • Day 1: 100 mg
  • Day 2: 900 mg
  • Day 8: 1000 mg
  • Day 15: 1000 mg

After the first cycle, patients typically receive 1000 mg on day 1 of each subsequent cycle. Treatment cycles are usually 21 or 28 days long, and patients may receive up to 8 cycles of treatment[2].

Effectiveness of Obinutuzumab

Clinical trials have shown that Obinutuzumab can be effective in treating various blood cancers. For example:

  • In follicular lymphoma, Obinutuzumab has shown superior results compared to older treatments like rituximab, both in newly diagnosed patients and those whose cancer has returned after previous treatment[4].
  • In chronic lymphocytic leukemia, Obinutuzumab has demonstrated effectiveness when combined with other medications[4].
  • For post-transplant lymphoproliferative disorder, early studies suggest that Obinutuzumab may be effective in patients whose cancer has returned or not responded to other treatments[3].

The effectiveness of Obinutuzumab can be measured in several ways, including:

  • Overall response rate: The percentage of patients whose cancer shrinks or disappears after treatment
  • Complete response rate: The percentage of patients whose cancer completely disappears after treatment
  • Progression-free survival: How long patients live without their cancer getting worse
  • Overall survival: How long patients live after starting treatment

Potential Side Effects

Like all medications, Obinutuzumab can cause side effects. Some of the most common include:

  • Infusion-related reactions: These can occur during or within 24 hours of receiving the medication and may include fever, chills, and difficulty breathing[1].
  • Increased risk of infections: Because Obinutuzumab affects the immune system, it can increase the risk of developing infections[7].
  • Low blood cell counts: Obinutuzumab can cause a decrease in various types of blood cells, which can lead to fatigue, increased risk of bleeding, or increased risk of infection[1].

Your healthcare team will monitor you closely for these and other potential side effects during treatment.

Ongoing Research

Researchers continue to study Obinutuzumab to learn more about its effectiveness and safety. Some areas of ongoing research include:

  • Using Obinutuzumab in combination with other medications to improve treatment outcomes[8]
  • Testing Obinutuzumab in patients whose cancer has returned after previous treatments[3]
  • Exploring the use of Obinutuzumab in other conditions, such as kidney diseases[6][7]
  • Studying the long-term effects of Obinutuzumab treatment[5]

These ongoing studies help doctors better understand how to use Obinutuzumab effectively and safely in different patient groups.

Condition Trial Phase Key Outcomes Measured Dosing Regimen
Follicular Lymphoma Phase II Overall response rate, Progression-free survival, Overall survival 1000 mg IV on days 1, 8, 15 of cycle 1, then day 1 of subsequent cycles
Chronic Lymphocytic Leukemia Phase II Complete remission rate, Progression-free survival, Overall survival 1000 mg IV on days 1, 8, 15 of cycle 1, then day 1 of subsequent cycles
Membranous Nephropathy Pilot Study Complete or partial remission of nephrotic syndrome, Adverse events 1000 mg IV on days 1, 15, 29, 43
Mantle Cell Lymphoma Phase II Molecular response rate, Progression-free survival, Overall survival 1000 mg IV on days 1, 8, 15, 22
Immune Thrombocytopenia Phase II Overall response rate, Sustained response rate, Safety 1000 mg IV single dose

Ongoing Clinical Trials on Obinutuzumab

  • Study of Obinutuzumab treatment for patients with non-infectious cryoglobulinemia vasculitis who did not respond to or cannot tolerate Rituximab

    Recruiting

    2 1 1 1
    Investigated drugs:
    France
  • Study of sonrotoclax plus obinutuzumab or rituximab compared to venetoclax plus rituximab in patients with relapsed or refractory chronic lymphocytic leukemia

    Recruiting

    3 1 1 1
    Austria Belgium Czechia Denmark France Germany +6
  • Study of BGB-16673 in combination with drug therapy for patients with relapsed or refractory B-cell malignancies

    Recruiting

    1 1 1 1
    Germany Italy Poland
  • Study of glofitamab, obinutuzumab and tocilizumab in patients with mantle cell lymphoma relapsed or refractory after CAR‑T therapy

    Recruiting

    2 1 1 1
    Italy
  • A study to compare glofitamab against a drug combination for patients with relapsed or refractory mantle cell lymphoma

    Recruiting

    3 1 1 1
    France Italy Spain Sweden
  • Obinutuzumab treatment for adults with frequently relapsing idiopathic nephrotic syndrome who are dependent on rituximab

    Recruiting

    2 1 1 1
    Investigated diseases:
    Investigated drugs:
    Italy
  • Study of Glofitamab and Pirtobrutinib Treatment in Patients with Mantle Cell Lymphoma Who Have Failed Previous Therapy and in Previously Untreated Patients

    Recruiting

    2 1 1 1
    Investigated diseases:
    Denmark Germany Norway Spain Sweden
  • Study comparing standard and reduced intensity treatment in patients with acute myeloid leukemia or chronic lymphocytic leukemia who have no detectable disease after initial therapy

    Recruiting

    3 1 1 1
    Investigated diseases:
    France Germany Poland
  • Study on Obinutuzumab for Patients with Relapsing Granulomatosis with Polyangiitis

    Recruiting

    2 1 1 1
    Investigated diseases:
    Investigated drugs:
    France
  • Study on Venetoclax, Obinutuzumab, and Pirtobrutinib for Patients with Untreated Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

    Recruiting

    3 1 1 1
    Austria Belgium Czechia Denmark Finland France +8

Glossary

  • Monoclonal antibody: A type of protein made in the laboratory that can bind to substances in the body, including cancer cells. Monoclonal antibodies are used to treat some types of cancer and other diseases.
  • CD20: A protein found on the surface of B cells, which are a type of white blood cell. CD20 is the target of obinutuzumab and some other cancer treatments.
  • Lymphoma: A type of cancer that begins in cells of the lymph system, which is part of the body's immune system.
  • Chronic lymphocytic leukemia (CLL): A type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell).
  • Follicular lymphoma: A type of non-Hodgkin lymphoma that begins in the follicles (clusters of cells) in the lymph nodes.
  • Mantle cell lymphoma: A rare type of B-cell non-Hodgkin lymphoma that usually occurs in middle-aged or older adults.
  • Immune thrombocytopenia (ITP): A blood disorder characterized by a decrease in the number of platelets in the blood, which can lead to easy bruising and bleeding.
  • Membranous nephropathy: A kidney disorder that causes problems with the filtering of waste products from the blood.
  • Intravenous (IV) infusion: A method of delivering medications directly into a vein using a needle or catheter.
  • Progression-free survival (PFS): The length of time during and after treatment that a patient lives with the disease but it does not get worse.
  • Overall survival (OS): The length of time from either the date of diagnosis or the start of treatment for a disease that patients are still alive.
  • Complete response (CR): The disappearance of all signs of cancer in response to treatment.
  • Partial response (PR): A decrease in the size of a tumor, or in the extent of cancer in the body, in response to treatment.

References