The efficacy, safety, and rationale of orelabrutinib combined with obinutuzumab (O2) as a first-line systemic treatment for marginal zone lymphoma

Marginal zone lymphoma (MZL) is an indolent B-cell malignancy characterized by protracted clinical courses, frequent relapses, and significant biological heterogeneity. The current frontline standard of care relies heavily on rituximab-based immunochemotherapy. While these regimens effectively induce remissions, they are intrinsically linked to cumulative toxicities—including neuropathy, prolonged myelosuppression, and the latent risk of secondary malignancies—that compromise long-term quality of life [ 1 , 2 ]. Consequently, defining highly efficacy, chemotherapy-free alternatives remain a critical unmet need in previously systematic untreated MZL patients.