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December 8, 2025Blood

ZAP trial: MRD-guided chemotherapy and maintenance de-escalation with zanubrutinib-g-CHOP in high-risk FL (Phase II)

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Authors

ZQZhengzi QianWLWei LiLQLihua Qiu

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Overview

Phase II trial demonstrates high complete response and minimal residual disease rates with zanubrutinib, indicating a promising de-escalation strategy in high-risk FL.

Key Points

  • To evaluate the efficacy of MRD-guided chemotherapy de-escalation integrating zanubrutinib in high-risk follicular lymphoma patients.
  • Phase II trial enrolled 32 untreated FL patients (FLIPI 2-5) from April 2024 to December 2024.
  • Patients received 4 cycles of zanubrutinib and G-CHOP with pegfilgrastim prophylaxis.
  • Response-adapted therapy based on complete response and MRD status was implemented.
  • Primary endpoint achieved with a complete response rate of 84.4% after 4 cycles.
  • Greater than 90% of patients achieved minimal residual disease negativity confirmed via ctDNA and bone marrow testing.
  • Patient-reported outcomes show significant improvement in quality of life scores post-induction.

Cite This Study

Qian et al. (2025) studied this question.

synapsesocial.com/papers/69362f6c4fa91c937236e01chttps://doi.org/10.1182/blood-2025-5380
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Zanubrutinib combined with bendamustine and rituximab in previously untreated patients with advanced follicular lymphoma: A prospective, open-label, single-arm phase II clinical study2025
  2. 2Zanubrutinib plus obinutuzumab induces promising efficacy and a manageable safety profile in previously untreated high-tumor-burden follicular lymphoma2025 · 1 citations
  3. 3Efficacy and safety of zanubrutinib combined with anti-CD20 monoclonal antibody-based regimens as first-line therapy in high-risk follicular lymphoma and marginal zone lymphoma: A single-arm retrospective study2025
  4. 4Efficacy and safety of zanubrutinib combined with g-CVP (Obinutuzumab, Cyclophosphamide, Vindesine, Prednisone) for first-line treatment of follicular lymphoma2025
  5. 5Zanubrutinib combined with R-CHOP in previously untreated diffuse large B-cell lymphoma with specific gene alteration: a phase II study2026