{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:52:39Z","timestamp":1792036359890,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Follicular lymphoma (FL) first\u2010line chemoimmunotherapy yields high efficacy but serious toxicity in 65% of patients. In high tumour burden treatment\u2010na\u00efve FL, we aimed to exploit known immunostimulatory and cytotoxic properties of combination checkpoint inhibition (atezolizumab) and obinutuzumab (6\u2009cycles) with positron emission tomography (PET)\u2010adapted ultra\u2010low dose radiotherapy (RT; 4Gy) to all PET\u2010avid sites after cycle 2, followed by 2\u2009years of obinutuzumab maintenance. Sixteen eligible patients were enrolled (15 evaluable for response) to our Phase II trial (NCT04962126). Median age was 53\u2009years with 94% intermediate\/high Follicular Lymphoma International Prognostic Index (FLIPI) score. The primary end\u2010point of complete response (CR) was achieved in 93% (95% confidence interval [CI]: 70%\u201399%) with objective response rate (ORR) of 100% (95% CI: 75%\u2013100%). With 41\u2010month median follow\u2010up, 3\u2010year progression\u2010free survival (PFS) was 80% (95% CI: 55\u201393) and OS was 100% (95% CI: 79.6\u2013100). Grade 3\u20134 adverse events occurred in 31% of patients (2 immune\u2010related). Baseline PET radiomics and immune transcriptomics demonstrated profiles suggesting promise as predictive markers of immunotherapy response, consistent with our prior findings. The novel multimodality combination of obinutuzumab, atezolizumab and ultra\u2010low dose nodal RT in treatment\u2010na\u00efve FL has promising efficacy and safety, offering a potential novel chemo\u2010free option. Further studies using low\u2010cost RT to augment immunotherapy are warranted.<\/jats:p>\n                  <jats:p>\n                    This trial was registered in\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>\n                    , registration number: NCT04962126.\n                  <\/jats:p>","DOI":"10.1111\/bjh.70468","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T13:51:09Z","timestamp":1775656269000},"page":"2026-2035","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Checkpoint inhibitors, obinutuzumab plus\n                    <scp>PET<\/scp>\n                    \u2010adapted ultra\u2010low dose nodal radiotherapy yield high efficacy in treatment\u2010na\u00efve follicular lymphoma: Results from the phase\n                    <scp>II<\/scp>\n                    \u2018\n                    <scp>FLUORO\u2019<\/scp>\n                    study"],"prefix":"10.1111","volume":"208","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3094-8867","authenticated-orcid":false,"given":"Arina","family":"Martynchyk","sequence":"first","affiliation":[{"name":"Clinical Haematology Austin Health  Heidelberg Australia"},{"name":"Olivia Newton\u2010John Cancer Research Institute  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4006-2380","authenticated-orcid":false,"given":"Geoffrey","family":"Chong","sequence":"additional","affiliation":[{"name":"Clinical Haematology Austin Health  Heidelberg Australia"},{"name":"Olivia Newton\u2010John Cancer Research Institute  Melbourne Australia"},{"name":"Grampians Health  Ballarat Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Khor","sequence":"additional","affiliation":[{"name":"Olivia 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