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NCT03332017: ROSEWOOD

A Study Comparing Obinutuzumab and BGB-3111 Versus Obinutuzumab Alone in Treating R/R Follicular Lymphoma

Completed Phase 2 Results posted Last updated 18 February 2026
What this trial tests

Phase 2 trial testing Zanubrutinib in Relapsed/Refractory Follicular Non-Hodgkin Lymphoma in 217 participants. Completed in 27 December 2024.

Timeline
14 November 2017
Primary endpoint
8 October 2021
27 December 2024

Quick facts

Lead sponsorBeiGene
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment217
Start date14 November 2017
Primary completion8 October 2021
Estimated completion27 December 2024
Sites88 locations across France, Italy, New Zealand, Russia, Taiwan, United Kingdom, Germany, Poland

Drugs / interventions tested

Conditions studied

Sponsor

BeiGene — full company profile →

Who can join

18 and older, any sex, with Relapsed/Refractory Follicular Non-Hodgkin Lymphoma. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Overall Response Rate (ORR) by Independent Central Review (ICR) Assessment Primary · From first dose to primary analysis data cutoff (08OCT2021) start of a new anticancer therapy, or the crossover date, whichever came first. Median follow-up was 12.45 months.

ORR was defined as the percentage of participants who achieved a best overall response of complete response (CR) or partial response (PR) per the Lugano Classification for Non-Hodgkin's Lymphoma.

GroupValue95% CI
Obinutuzumab45.834.0 – 58.0
Zanubrutinib + Obinutuzumab68.360.0 – 75.7
Overall Response Rate (ORR) as Assessed by the Investigator Secondary · From first dose to primary analysis data cutoff (08OCT2021) start of a new anticancer therapy, or the crossover date, whichever came first. Median follow-up was 12.45 months.

ORR was defined as the percentage of participants who achieved a best overall response of complete response (CR) or partial response (PR) per the Lugano Classification for Non-Hodgkin's Lymphoma.

GroupValue95% CI
Obinutuzumab41.730.2 – 53.9
Zanubrutinib + Obinutuzumab66.257.9 – 73.8
Duration of Response (DOR) as Determined by Investigator Assessment Secondary · From first dose to primary analysis data cutoff (08OCT2021) start of a new anticancer therapy, or the crossover date, whichever came first. Median follow-up was 12.45 months.

DOR was defined as the time from the date that a confirmed response (CR or PR) was first observed to the date of first documented disease progression or death, whichever occurred first. For participants in the monotherapy arm who crossed over to combination therapy, disease assessments after crossover were not included in the DOR calculation. Median DOR was estimated using the Kaplan-Meier method.

GroupValue95% CI
Obinutuzumab9.23.8 – NA
Zanubrutinib + Obinutuzumab30.624.7 – NA
DOR as Determined by ICR Secondary · From first dose to primary analysis data cutoff (08OCT2021) start of a new anticancer therapy, or the crossover date, whichever came first. Median follow-up was 12.45 months.

DOR was defined as the time from the date that a confirmed response (CR or PR) was first observed to the date of first documented disease progression or death, whichever occurred first. For participants in the monotherapy arm who crossed over to combination therapy, disease assessments after crossover were not included in the DOR calculation. Median DOR was estimated using the Kaplan-Meier method.

GroupValue95% CI
ObinutuzumabNA9.0 – NA
Zanubrutinib + ObinutuzumabNA24.7 – NA
Progression-free Survival (PFS) Secondary · From first dose to primary analysis data cutoff (08OCT2021) start of a new anticancer therapy, or the crossover date, whichever came first. Median follow-up was 12.45 months.

PFS was defined as the time from randomization to the date of first documented disease progression or death from any cause, whichever occurred first, as determined by the ICR or investigator assessment. For participants in the monotherapy arm who crossed over to combination therapy, disease assessments after crossover were not included in the PFS calculation. Median PFS was estimated using the Kaplan-Meier method.

ICR
GroupValue95% CI
Obinutuzumab11.26.5 – 15.7
Zanubrutinib + Obinutuzumab27.416.1 – NA
Investigator
GroupValue95% CI
Obinutuzumab5.83.7 – 8.2
Zanubrutinib + Obinutuzumab22.211.3 – NA
Overall Survival (OS) Secondary · From first dose to primary analysis data cutoff (08OCT2021) start of a new anticancer therapy, or the crossover date, whichever came first. Median follow-up was 12.45 months.

OS was defined as the time from randomization to the date of death from any cause. Median OS was estimated using the Kaplan-Meier method.

GroupValue95% CI
ObinutuzumabNA26.8 – NA
Zanubrutinib + ObinutuzumabNA31.4 – NA
Complete Response Rate Secondary · From first dose to primary analysis data cutoff (08OCT2021) start of a new anticancer therapy, or the crossover date, whichever came first. Median follow-up was 12.45 months.

CRR was defined as the percentage of participants who achieved a complete response or complete metabolic response as their best overall response, as determined by ICR and investigator assessment. Responses were assessed from randomization until the data cutoff date, the start of a new anticancer therapy, or the crossover date for participants in the monotherapy arm who switched to combination therapy.

ICR
GroupValue95% CI
Obinutuzumab19.411.1 – 30.5
Zanubrutinib + Obinutuzumab37.229.4 – 45.7
Investigator
GroupValue95% CI
Obinutuzumab19.411.1 – 30.5
Zanubrutinib + Obinutuzumab29.021.7 – 37.1
Time to Response (TTR) Secondary · From first dose to primary analysis data cutoff (08OCT2021) start of a new anticancer therapy, or the crossover date, whichever came first. Median follow-up was 12.45 months.

TRR was defined as the time from randomization to the first date that response criteria (CR or PR) were met, as determined by ICR and investigator assessment. Only participants who achieved an overall response were included in the analysis. For participants in the monotherapy arm who crossed over to combination therapy, disease assessments after crossover were not included in the TRR calculation.

ICR
GroupValue95% CI
Obinutuzumab2.832.5 – 6.5
Zanubrutinib + Obinutuzumab2.832.0 – 14.0
Investigator
GroupValue95% CI
Obinutuzumab2.792.5 – 16.6
Zanubrutinib + Obinutuzumab2.792.0 – 16.9
Change From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) Global Health Status (GHS)/Quality of Life (QOL), Physical Functioning, Role Functioning, and Symptom Scores Secondary · Baseline, Week 12, and Week 24

The EORTC QLQ-C30 includes 30 questions covering 5 functional scales (physical, role, emotional, cognitive, social), 1 global health scale, 3 symptom scales (fatigue, nausea/vomiting, pain), and 6 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, financial difficulties). Participants report their health over the past week. Most items use a 4-point scale (1 = Not at all to 4 = Very much), while 2 global QOL items use a 7-point scale (1 = Very poor to 7 = Excellent). Raw scores are linearly transformed to a 0-100 scale; higher GHS and functional scores and lower symptom sco

Global Health Status/QOL: Week 12
GroupValue95% CI
Obinutuzumab-2.222± 16.9856
Zanubrutinib + Obinutuzumab4.023± 16.2440
Global Health Status/QOL: Week 24
GroupValue95% CI
Obinutuzumab4.955± 15.1458
Zanubrutinib + Obinutuzumab2.577± 17.3623
Physical Function: Week 12
GroupValue95% CI
Obinutuzumab-1.449± 13.2526
Zanubrutinib + Obinutuzumab0.361± 13.8192
Physical Function: Week 24
GroupValue95% CI
Obinutuzumab0.270± 10.2553
Zanubrutinib + Obinutuzumab0.412± 11.4186
Role Function: Week 12
GroupValue95% CI
Obinutuzumab1.812± 25.6347
Zanubrutinib + Obinutuzumab2.730± 22.9412
Role Function: Week 24
GroupValue95% CI
Obinutuzumab-0.901± 21.1352
Zanubrutinib + Obinutuzumab3.093± 17.4022
Fatigue: Week 12
GroupValue95% CI
Obinutuzumab2.657± 19.3424
Zanubrutinib + Obinutuzumab-1.947± 19.5647
Fatigue: Week 24
GroupValue95% CI
Obinutuzumab-0.150± 15.0722
Zanubrutinib + Obinutuzumab-2.291± 18.4911
Change From Baseline in European Quality of Life 5-Dimensions, 5-level (EQ-5D-5L) Visual Analogue Scale (VAS) Secondary · Baseline, Week 12, and Week 24

The EQ-5D-5L measures health outcomes using a VAS to record a participant's self-rated health on a scale from 0 to 100, where 100 is 'the best health you can imagine' and 0 is 'the worst health you can imagine.' A higher score indicates better health outcomes.

Week 12
GroupValue95% CI
Obinutuzumab-0.3± 14.96
Zanubrutinib + Obinutuzumab2.4± 16.71
Week 24
GroupValue95% CI
Obinutuzumab2.0± 14.17
Zanubrutinib + Obinutuzumab3.1± 15.95
Number of Participants Experiencing Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) Secondary · From first dose to 30 days after zanubrutinib, 90 days after obinutuzumab, or before new therapy, whichever came first, up to study cut-off (31 Dec 2024); maximum exposure was 28.7 months for obinutuzumab and 67.4 months for combination therapy.

An adverse event refers to any unintended or unfavorable sign, symptom, or condition (including abnormal lab results) that occurs during the study, regardless of whether it is linked to the study drug.

At Least One TEAE
GroupValue95% CI
Obinutuzumab65
Zanubrutinib + Obinutuzumab137
At Least One SAE
GroupValue95% CI
Obinutuzumab22
Zanubrutinib + Obinutuzumab75
Area Under the Curve (AUCss) of Zanubrutinib at Steady State Secondary · Cycle 1 Day 1 and Cycle 2 Day 1: Predose (within 30 minutes before zanubrutinib dosing) and 2 hours (± 30 minutes) post-dose.

Pharmacokinetic exposure parameters were estimated for each participant using a population pharmacokinetic (PK) model.

GroupValue95% CI
Zanubrutinib + Obinutuzumab2203.619021± 1045.430371

Adverse events — posted to ClinicalTrials.gov

Time frame: All-cause mortality was reported up to the end of study, max time on study was approximately 70 months. AEs were reported from first dose to 30 days after zanubrutinib, 90 days after obinutuzumab, or before new therapy, whichever came first, up to study cut-off date (31 Dec 2024); maximum exposure was 28.7 months for obinutuzumab and 67.4 months for combination therapy.. Reporting threshold: 3%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Obinutuzumab Monotherapy
Serious: 22/71 (31%)
Deaths: 33/72
Zanubrutinib Plus Obinutuzumab
Serious: 75/143 (52%)
Deaths: 51/145
Crossover Treatment
Serious: 20/36 (56%)
Deaths: 16/36

Serious adverse events (119 terms)

ReactionSystemObinutuzumab MonotherapyZanubrutinib Plus Obinutuz…Crossover Treatment
PneumoniaInfections and infestations
COVID-19Infections and infestations
COVID-19 pneumoniaInfections and infestations
ThrombocytopeniaBlood and lymphatic system disorders
Lower respiratory tract infectionInfections and infestations
Febrile neutropeniaBlood and lymphatic system disorders
Atrial fibrillationCardiac disorders
DeathGeneral disorders
Multiple organ dysfunction syndromeGeneral disorders
PyrexiaGeneral disorders
Anal abscessInfections and infestations
Septic shockInfections and infestations
Urinary tract infectionInfections and infestations
FallInjury, poisoning and procedural complications
Myelodysplastic syndromeNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Tumour painNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Pleural effusionRespiratory, thoracic and mediastinal disorders
AnaemiaBlood and lymphatic system disorders
Necrotic lymphadenopathyBlood and lymphatic system disorders
Acute myocardial infarctionCardiac disorders
Aortic valve stenosisCardiac disorders
Cardiac failureCardiac disorders
Myocardial infarctionCardiac disorders
PericarditisCardiac disorders
Abdominal painGastrointestinal disorders
Other adverse events (78 terms — click to expand)

ReactionSystemObinutuzumab MonotherapyZanubrutinib Plus Obinutuz…Crossover Treatment
ThrombocytopeniaBlood and lymphatic system disorders
DiarrhoeaGastrointestinal disorders
Platelet count decreasedInvestigations
CoughRespiratory, thoracic and mediastinal disorders
FatigueGeneral disorders
PyrexiaGeneral disorders
COVID-19Infections and infestations
Neutrophil count decreasedInvestigations
AnaemiaBlood and lymphatic system disorders
NeutropeniaBlood and lymphatic system disorders
ConstipationGastrointestinal disorders
PneumoniaInfections and infestations
AstheniaGeneral disorders
White blood cell count decreasedInvestigations
DyspnoeaRespiratory, thoracic and mediastinal disorders
Upper respiratory tract infectionInfections and infestations
Back painMusculoskeletal and connective tissue disorders
Urinary tract infectionInfections and infestations
NauseaGastrointestinal disorders
NasopharyngitisInfections and infestations
ContusionInjury, poisoning and procedural complications
HypokalaemiaMetabolism and nutrition disorders
Herpes zosterInfections and infestations
Abdominal painGastrointestinal disorders
InsomniaPsychiatric disorders
PruritusSkin and subcutaneous tissue disorders
VomitingGastrointestinal disorders
PetechiaeSkin and subcutaneous tissue disorders
StomatitisGastrointestinal disorders
HypomagnesaemiaMetabolism and nutrition disorders
RashSkin and subcutaneous tissue disorders
HypogammaglobulinaemiaImmune system disorders
FallInjury, poisoning and procedural complications
Infusion related reactionInjury, poisoning and procedural complications
Weight decreasedInvestigations
Muscle spasmsMusculoskeletal and connective tissue disorders
EpistaxisRespiratory, thoracic and mediastinal disorders
HypertensionVascular disorders
SinusitisInfections and infestations
C-reactive protein increasedInvestigations

Most-reported serious reactions: Pneumonia, COVID-19, COVID-19 pneumonia, Thrombocytopenia, Lower respiratory tract infection, Febrile neutropenia, Atrial fibrillation, Death.

Data from ClinicalTrials.gov NCT03332017 adverse events section.

Sponsor's own description

This clinical study examined the safety and efficacy of the combination of zanubrutinib and obinutuzumab versus obinutuzumab alone in adults with follicular lymphoma whose disease returned after or did not respond to prior therapy.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Zanubrutinib: past, present, and future.
    Tam CS, Muñoz JL, Seymour JF, Opat S. · · 2023 · cited 35× · PMID 37696810 · DOI 10.1038/s41408-023-00902-x
  2. Prospects in the management of patients with follicular lymphoma beyond first-line therapy.
    Qualls D, Salles G. · · 2022 · cited 23× · PMID 34985231 · DOI 10.3324/haematol.2021.278717
  3. Current and future therapies for follicular lymphoma.
    Zinzani PL, Muñoz J, Trotman J. · · 2024 · cited 11× · PMID 39175100 · DOI 10.1186/s40164-024-00551-1
  4. Current Status of Novel Agents for the Treatment of B Cell Malignancies: What's Coming Next?
    Tannoury M, Garnier D, Susin SA, Bauvois B. · · 2022 · cited 10× · PMID 36551511 · DOI 10.3390/cancers14246026
  5. Patient-reported outcomes in patients with relapsed or refractory follicular lymphoma treated with zanubrutinib plus obinutuzumab versus obinutuzumab monotherapy: results from the ROSEWOOD trial.
    Trotman J, Zinzani PL, Song Y, Delarue R, et al · · 2024 · cited 2× · PMID 39376156 · DOI 10.1080/03007995.2024.2409837
  6. Comparative efficacy of zanubrutinib plus obinutuzumab versus last prior treatment in relapsed/refractory follicular lymphoma: growth modulation index analysis from the ROSEWOOD study.
    Trotman J, Bouabdallah K, Bijou F, Šálek D, et al · · 2026 · PMID 41922143 · DOI 10.1016/j.esmoop.2026.106942
  7. Poster Abstracts - Academy of Managed Care Pharmacy 2026
    · 2026
  8. Treatment and survival outcomes for patients with follicular lymphoma and POD24: a systematic review and meta-analysis.
    Shen J, Zhang J, Zhu Z, Ma H, et al · · 2026 · PMID 41587420 · DOI 10.1182/bloodadvances.2025018474

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