Highlights

Outside of the clinical trial setting, we’d normally administer an anti-CD20 antibody (typically rituximab or obinutuzumab) combined with chemotherapy. The majority of our patients would have rituximabbendamustine. If they achieve a remission after their standard induction treatment, I would discuss maintenance anti-CD20 interventions as well. This would continue for two years. That’s typical of the landscape in the front-line setting.

I think the main challenge is that drugs in the first-line setting are pretty effective already. We already saw with the GALLIUM and the RELEVANCE trials, where they tried to go head-to-head with standard rituximab-chemotherapy, they didn’t come out as superior. The overall response rate of rituximab-chemo is incredibly high, PFS is very high, so you need to have a wonder drug to be able to show superiority to the conventional rituximab regimens in first line… The challenge of course with FL trials – potentially another reason why there haven’t been any new front-line drugs – is that a Phase III trial is incredibly long and expensive due to the indolent nature of the disease. So to be able to capture the kind of progression-free survival data, you need a lot of time and money.