Relapsed Follicular Lymphoma Resistant to Rituximab (Rit-R) — What to Do Next
When follicular lymphoma relapses and is found to be resistant to rituximab, the available treatment options narrow significantly. This protocol addresses exactly that scenario and defines the recommended path forward.
Defining Rit-R: Rituximab resistance is defined as no response, or disease progression during or within 6 months after treatment with rituximab or a rituximab-containing regimen. Therapeutic options for these patients are more limited than for those who retain sensitivity to rituximab.
Recommended approach
For rituximab-refractory relapsed follicular lymphoma, a specific combination regimen involving obinutuzumab is recommended. The complete regimen, sequencing, and maintenance strategy are detailed in the full protocol…
References
- Therapeutic options for people with relapsed disease are more limited for those who are resistant to rituximab (Rit-R), i.e., people who did not respond or who progressed during or within 6 months after treatment with rituximab or a rituximab-containing regimen.
- Offer bendamustine in combination with obinutuzumab, for those people who are rituximab refractory.
- A Phase 3 study has demonstrated evidence for a benefit of obinutuzumab (see section Management of patients with newly diagnosed FL), when combined with bendamustine and followed by obinutuzumab maintenance for 2 years, compared with bendamustine alone.
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