Opat Stephen, Dickinson Michael, Cheah Chan Yoon, Tam Constantine, Boulos Joy, Thorburn Alison Nicole, Trotman Judith
School of Clinical Sciences, Monash Health, Monash University, Clayton, Melbourne, VIC, Australia.
Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia.
Asia Pac J Clin Oncol. 2019 May;15 Suppl 3:3-11. doi: 10.1111/ajco.13153.
Recently, obinutuzumab was included in the Australian Pharmaceutical Benefits Scheme for use in first line, advanced or bulky stage 2, follicular lymphoma, providing more immunochemotherapy treatment options available than ever before. Rituximab with chemotherapy has been the standard of care since reimbursement in the late 1990s; however, obinutuzumab-based regimens have shown superior progression-free survival in comparison to rituximab-based options, albeit at an increased risk of grade ≥3 adverse events. As median overall survival approaches 20 years or more, the long-term effects and sequencing of any strategy should be considered. Here we discuss the considerations for selection of front-line therapy, based on evidence and local Australian clinician experience, in the management of first line follicular lymphoma.
