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Systemic Anti-Cancer Therapy Regimen Library

Home > LYM NHL B-cell - bendamustine and oBINUTUZumab

LYM NHL B-cell - bendamustine and oBINUTUZumab

Treatment Overview

This regimen consists of 2 parts:

  1. bendamustine and oBINUTUZumab Induction for up to 6 cycles, followed approximately 2 months after last dose of oBINUTUZumab by
  2. oBINUTUZumab Maintenance for up to 2 years, or until disease progression or unacceptable toxicity.
bendamustine and oBINUTUZumab Induction

For up to 6 cycles.

Followed approximately 2 months after last dose of oBINUTUZumab by

oBINUTUZumab Maintenance

For up to 2 years, or until disease progression or unacceptable toxicity.

Supportive Care Factors

Factor Value
Antiviral prophylaxis for hepatitis B virus: Required for anti–HBc positive patients at risk of reactivation
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis may be considered
Emetogenicity: Variable
Hypersensitivity / Infusion related reaction risk: High - routine premedication recommended
Irradiated blood components: Irradiation of blood components is recommended
Pneumocystis jirovecii pneumonia (PJP) prophylaxis: Routine antibiotic prophylaxis may be considered
Tumour lysis syndrome prophylaxis: Variable

References

Roche Products (New Zealand) Limited Gazyva® New Zealand data sheet 21 July 2022 https://www.medsafe.govt.nz/profs/datasheet/g/GazyvaInfusion.pdf (accessed 17 October 2023).

Haage, T. R., A. Surov, D. Mougiakakos, et al. 2022. "Successful Use of Intravenous Immunoglobulins in an Obinutuzumab-related Acute Thrombocytopenia." Hemasphere 6(8):e751., PMID: 35935607

Fujiwara, Y., T. Urata, D. Niiya, et al. 2022. "Higher incidence of thrombocytopenia during obinutuzumab plus bendamustine therapy for untreated follicular lymphoma: a retrospective analysis by the Okayama Hematology Study Group." Int J Hematol 115(6):811-815., PMID: 35583725

Marcus, R., A. Davies, K. Ando, et al. 2017. "Obinutuzumab for the First-Line Treatment of Follicular Lymphoma." N Engl J Med 377(14):1331-1344., PMID: 28976863

Hiddemann, W., A. M. Barbui, M. A. Canales, et al. 2018. "Immunochemotherapy With Obinutuzumab or Rituximab for Previously Untreated Follicular Lymphoma in the GALLIUM Study: Influence of Chemotherapy on Efficacy and Safety." J Clin Oncol 36(23):2395-2404., PMID: 29856692

Trotman, J., S.F. Barrington, D. Belada, et al. 2018. "Prognostic value of end-of-induction PET response after first-line immunochemotherapy for follicular lymphoma (GALLIUM): secondary analysis of a randomised, phase 3 trial." Lancet Oncol 19(11):1530-1542., PMID: 30309758

Sehn, L. H., N. Chua, J. Mayer, et al. 2016. "Obinutuzumab plus bendamustine versus bendamustine monotherapy in patients with rituximab-refractory indolent non-Hodgkin lymphoma (GADOLIN): a randomised, controlled, open-label, multicentre, phase 3 trial." Lancet Oncol 17(8):1081-1093., PMID: 27345636

Cheson, B. D., N. Chua, J. Mayer, et al. 2018. "Overall Survival Benefit in Patients With Rituximab-Refractory Indolent Non-Hodgkin Lymphoma Who Received Obinutuzumab Plus Bendamustine Induction and Obinutuzumab Maintenance in the GADOLIN Study." J Clin Oncol 36(22):2259-2266., PMID: 29584548

New Zealand Blood Service Transfusion Medicine Handbook Third Edition, 2016 https://www.nzblood.co.nz/assets/Transfusion-Medicine/PDFs/111G122.pdf (accessed 16 June 2022).

Doyle J, Raggatt M, Slavin M, McLachlan SA, Strasser SI, Sasadeusz JJ, Howell J, Hajkowicz K, Nandurkar H, Johnston A, Bak N, Thompson AJ. Hepatitis B management during immunosuppression for haematological and solid organ malignancies: an Australian consensus statement. Med J Aust. 2019 Jun;210(10):462-468. doi: 10.5694/mja2.50160. Epub 2019 May 19., PMID: 31104328

Medicines and Hepatitis B Reactivation Prescriber Update 38(1): 2-3 March 2017 https://medsafe.govt.nz/profs/PUArticles/March2017/MedicinesAndHepatitisB.htm

Rituximab and Hepatitis B Reactivation Prescriber Update 34(3):27 September 2013 https://www.medsafe.govt.nz/profs/PUArticles/Sept2013RituximabHepB.htm

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.