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Chlorambucil + obinutuzumab is a combination therapy used primarily for the initial treatment of previously untreated chronic lymphocytic leukemia (CLL) in patients with comorbidities. Chlorambucil is an alkylating agent that interferes with DNA replication and transcription by cross-linking DNA, resulting in cytotoxicity towards rapidly dividing cells. Obinutuzumab is a humanized, glycoengineered type II anti-CD20 monoclonal antibody that targets the CD20 antigen on B-lymphocytes, inducing B-cell lysis via multiple mechanisms including direct cell death, antibody-dependent cellular cytotoxicity (ADCC), and antibody-dependent cellular phagocytosis (ADCP). The combination improves progression-free survival and overall response rate compared to chlorambucil alone, and is administered intravenously[1][3][5][6].
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