Genentech announced statistically significant and clinically meaningful results from the Phase III INShore study of Gazyva® (obinutuzumab) in children and young adults aged 2-25 years with idiopathic nephrotic syndrome (INS). The study met its primary endpoint, demonstrating that significantly more patients achieved sustained complete remission at one year with Gazyva compared to mycophenolate mofetil (MMF), the current standard of care.
Breakthrough Results in Pediatric Kidney Disease
The INShore trial enrolled 85 children and young adults who were randomized 1:1 to receive either Gazyva at weeks 0, 2, 24, and 26, or daily MMF. Sustained complete remission was defined by the absence of relapses during the study together with a low amount of protein in the urine (protein to creatinine ratio of 0.2 or less) at week 52.
"These results show that Gazyva may achieve robust disease control with a reduced need for corticosteroids, which are associated with serious side effects over time," said Levi Garraway, M.D., Ph.D., chief medical officer and head of Global Product Development at Genentech. "Idiopathic nephrotic syndrome is a severe and chronic kidney disease usually diagnosed in early childhood, yet meaningful treatment progress has been limited."
Addressing Critical Unmet Medical Need
For several decades, treatment for idiopathic nephrotic syndrome has primarily relied on steroids, yet relapse rates remain high and long-term use is limited by serious side effects. The disease is characterized by unpredictable relapses that cause fatigue, swelling, weight gain, and increased susceptibility to infections and clotting, as well as anxiety, depression, and reduced self-esteem brought on by the fear of relapse and social isolation.
Current treatment approaches show significant limitations, with relapse rates exceeding 70% and serious side effects that limit long-term steroid use. This creates an urgent need for new targeted treatment approaches that can sustain remission and reduce the physical and psychosocial burden of the disease.
Comprehensive Secondary Endpoint Success
Analysis of key secondary endpoints revealed statistically significant and clinically meaningful benefits with Gazyva treatment. Patients receiving Gazyva showed increased overall relapse-free survival, extended median time to relapse or death, significant reduction in cumulative corticosteroid dose from baseline to week 52, and fewer relapses compared to MMF treatment.
The safety profile remained consistent with the well-characterized profile of Gazyva in adults, with no new safety signals identified during the study period.
Expanding B-Cell Targeting Strategy
INShore data contribute to a growing body of evidence, including the Phase III REGENCY study in lupus nephritis, demonstrating that targeting disease-causing B cells with Gazyva may help address disease activity across a spectrum of immune-mediated kidney and kidney-related diseases. Newer approaches that target specific immune cells, such as B cells thought to be a key driver of disease activity, may help control symptoms more effectively.
In October 2025, Gazyva received approval in the United States for treating adults with active lupus nephritis who are receiving standard therapy, based on data from the Phase III REGENCY and Phase II NOBILITY studies.
Regulatory Path Forward
Data from the INShore study will be presented at an upcoming medical meeting and shared with health authorities, including the U.S. Food and Drug Administration and the European Medicines Agency. If approved, Gazyva could help children and young adults sustain remission, potentially with a reduced need for steroids to manage their disease.
Gazyva is a Type II engineered humanized monoclonal antibody designed to attach to CD20, a protein found on certain types of B cells. The drug is currently approved in 100 countries for various types of hematological cancers and represents part of Genentech's broader strategy to become leaders in immune-mediated kidney and kidney-related diseases.
Beyond idiopathic nephrotic syndrome, Gazyva is being investigated in membranous nephropathy, lupus nephritis, rare immune-mediated kidney diseases, and systemic lupus erythematosus as part of the company's comprehensive immunology pipeline.
