Future Treatment Landscape of MZL


Closing out their discussion on marginal zone lymphoma, the panel considers which future treatment strategies are most promising.


Bhavesh Shah, RPh, BCOP: We’re getting close to the end of our session, and I wanted to also talk about what you guys are excited about in the pipeline for marginal zone lymphoma. ASH [American Society of Hematology Annual Meeting] will be held December 11-14, 2021. Is there anything that you’re looking forward to? We’ll start with you, Amit, and then go to Javier.

Amitkumar Mehta, MD: There are so many exciting treatments coming up for B-cell lymphomas. The space is getting more crowded every day. One that comes to mind that Javier mentioned is Zuma-5, which focused on CAR [chimeric antigen receptor] T-cell therapy. The response rates were pretty impressive in the marginal zone lymphoma world. They weren’t as good as in follicular, but they were pretty impressive. CAR T is one that I’m very excited about. The second class of agents rolling out is bispecific antibodies. There are multiple bispecific antibodies, at least 4 that I know, that are CD20/CD3-bispecific, and I’m sure we’ll see even more targets in the future. CD19 is also a very attractive target. We know that tafasitamab [Monjuvi] and CD19 antibody-drug conjugate loncastuximab [Zynlonta] are also very active in B-cell lymphomas. Then some of the others include anti-SIRPα and anti-CD47. There are also anti-SUMOylation protein inhibitors. There are so many agents rolling out. I’m sure this ASH will be very busy and will show even more activation in that setting.

Bhavesh Shah, RPh, BCOP: Yes, there’s so much to look forward to. As you said, it’s getting flooded. It’s a good thing. Javier, I want to give you the opportunity also.

Javier Munoz, MD, MBA: Absolutely, I agree 100% with Amit. In general, I’m very excited about CAR T-cell therapies. To be fair and balanced, the responses were underwhelming in marginal zone lymphoma compared with follicular lymphoma with the autologous CAR T cells, but we’ll have other constructs coming down the pipeline targeting perhaps not only CD19, but tandem targets like CD19 and CD20 or CD19 and CD22. We’ll also have the allogeneic CAR T cells. That’s interesting because it will be off the shelf and you won’t have to wait the 2 or 3 weeks that we usually have to wait for the manufacturing of the autologous CAR T cells. I’m also really excited about the bispecifics. There are also some attractive antibody-drug conjugates. Overall, I’m really happy that it’s going to be an exciting ASH. Thank you.

Bhavesh Shah, RPh, BCOP: Absolutely. We probably just talked about at least 10 different treatments that are coming in the near future for this disease. You’re definitely correct that ASH is going to be absolutely amazing to see all this innovation coming through. I want to thank both of you guys and our audience for taking the time to listen to our panel session. We hope you found this Pharmacy Times® Insights program to be rich and informative. Thank you so much.

Transcript edited for clarity.

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