Real-world effectiveness and safety of Zanubrutinib in Spanish patients with relapsed/refractory marginal zone lymphoma.
Year: 2026
Type: article
Study design: Observational Study
Abstract: There is no established standard treatment of relapsed/refractory (R/R) marginal zone lymphoma (MZL). Zanubrutinib was approved in this setting based on the phase II MAGNOLIA trial. We retrospectively evaluated the characteristics and outcomes of 118 real-world patients in Spain with R/R MZL treated with zanubrutinib after at least one prior anti-CD20-based regimen. The median age at zanubrutinib initiation was 75 years, and 56% were female. MZL subtypes included splenic (55.3%), MALT (18.9%), nodal (19.8%), and non-classifiable (6%). The median number of prior lines of therapy (LoT) was 1.5 (range 1-7); 26% were refractory to the immediately preceding line, and 59% were POD24 to frontline. Thirty-one patients (26.3%) would not have met MAGNOLIA eligibility criteria, 68% had cardiovascular comorbidities, and 28% were receiving antithrombotic therapy. The overall and complete response rates were 76% and 22.2%, respectively, with no differences according to MZL subtype, age, POD24, or MAGNOLIA eligibility. Fewer prior LoT were associated with higher and deeper responses. With a median follow-up of 14 months, 1-year progression-free and overall survival were 79.4% and 86.8%, respectively. Zanubrutinib responders and patients with stable disease presented better outcomes than cases with progressing disease (p < 0.01). Adverse events (AEs) were reported in 34.1% of patients (grade ≥ 3 in 14.4%). MAGNOLIA-ineligible patients experienced a higher incidence of AEs, and bleeding events were more frequent among patients receiving anticoagulant therapy (p = 0.04). Overall, zanubrutinib demonstrated favorable effectiveness and safety in real-world R/R MZL, with improved outcomes when administered earlier in the disease.
Source: Blood Advances
Authors: Fernando Martin-Moro, Ana Muntanola Prat, Xabier Gutierrez Lopez De Ocariz, Maria Sofia Vazquez Diaz, Lucía Morais, Itxaso Amarika, Ramón Diez-Feijóo, Mariana Bastos-Oreiro, Beatriz de la Cruz Benito, Javier Marco Ayala, Sergio Ramos Cillan, Ana Jiménez-Ubieto, Pablo Galindo-Navarro, Juan Gonzalo Correa, Esperanza Lavilla Rubira, Cristina García-Herce, Miriam Moreno, Eva Domingo-Domenech, Nazaret Domínguez, Aranzazu Alonso, Maria José Otero, Alessandra Comai, Maria Luisa Bengochea Casado, Carolina Villegas, Norma C. Gutierrez, Rafael Lluch García, Sara Fernández-Luis, Joan-Alfons Soler, Jimena Cannata-Ortiz, Ángeles Medina, Sofía Martín-Consuegra, Marta Aceituno, Paola Villafuerte Gutierrez, Dunia de Miguel Llorente, José-María Arguiñano, Javier López-Marín, Lucia Villalon, Horacio Gulino, Armando López-Guillermo, Antonio Salar
Institutions: Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Universitario Ramón y Cajal, Hospital de Sant Pau, Hospital Universitario Araba, Hospital Juan Ramón Jiménez, Hospital Universitario Central de Asturias, Hospital de Galdakao, Hospital Del Mar, Hospital General Universitario Gregorio Marañón, Hospital Universitario La Paz, Hospital Universitario Fundación Jiménez Díaz, Hospital Universitario 12 De Octubre, Hospital Universitario Virgen de las Nieves, Hospital Clínic de Barcelona, Hospital Universitario Lucus Augusti, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Josep Carreras Leukaemia Research Institute, Institut Català d'Oncologia, Duran i Reynals Hospital, Hospital Universitario Virgen Macarena, Hospital Central de la Defensa Gómez Ulla, Hospital de Sant Joan Despí Moisès Broggi, Hospital Universitario Severo Ochoa, Hospital Arnau de Vilanova, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Hospital de Manises, Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla, Corporació Sanitària Parc Taulí, Hospital Universitario de La Princesa, Complejo Hospitalario Universitario de Ferrol, Hospital Universitario Puerta de Hierro Majadahonda, Hospital Universitario de Guadalajara, Complejo Hospitalario de Navarra, Hospital General Universitario de Alicante Doctor Balmis, Hospital Universitario Fundación Alcorcón, Hospital General Nuestra Señora del Prado, Hospital Universitario Virgen de la Arrixaca
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,800
OpenAlex ID: W7204154814
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