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We investigated sources of variability in G exposure and association of progression\u2010free survival (PFS) with average concentration over induction (C<jats:sub>meanIND<\/jats:sub>) in front\u2010line follicular lymphoma patients treated with G plus chemotherapy (bendamustine, CHOP, or CVP) in the GALLIUM trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Individual exposures (C<jats:sub>meanIND<\/jats:sub>) were obtained from a previously established population pharmacokinetic model updated with GALLIUM data. Multivariate Cox proportional hazard models and univariate Kaplan\u2013Meier plots investigated relationships of PFS with exposure and other potential prognostic factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, G exposure was lower in high body\u2010weight patients and in males, and slightly lower in patients with high baseline tumour burden. Analysis of clinical outcomes showed that variability in G exposure did not impact PFS in G\u2010bendamustine\u2010treated patients; PFS was inferior in males and patients with FCGR2a\/2b T232\u00a0T low\u2010affinity receptor variant, and superior in patients with FCGR2a\/2b I232T variant. In G\u2010CHOP\/CVP arms, PFS improved with increasing C<jats:sub>meanIND<\/jats:sub> (hazard ratio\u00a0=\u00a01.74 and 0.394 at 5<jats:sup>th<\/jats:sup> and 95<jats:sup>th<\/jats:sup> percentile compared to median C<jats:sub>meanIND<\/jats:sub>) and was inferior in patients with high baseline tumour size and B symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>It remains unclear whether for G\u2010CHOP\/CVP patients lower G exposure is a consequence of adverse disease biology and\/or resistance to chemotherapy backbone (higher clearance in nonresponder patients, as demonstrated for rituximab) rather than being the cause of poorer clinical outcome. A study with &gt;1 dose level of G could help resolve this uncertainty.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.13920","type":"journal-article","created":{"date-parts":[[2019,3,13]],"date-time":"2019-03-13T21:33:21Z","timestamp":1552512801000},"page":"1495-1506","source":"Crossref","is-referenced-by-count":6,"title":["Role of obinutuzumab exposure on clinical outcome of follicular lymphoma treated with first\u2010line immunochemotherapy"],"prefix":"10.1111","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7018-9687","authenticated-orcid":false,"given":"Candice","family":"Jamois","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology F. 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