Treatment patterns in relapsed/refractory marginal zone lymphoma: real-world evidence from seven countries

BACKGROUND: Given the rarity of marginal zone lymphoma (MZL), real-world data on relapsed/refractory (R/R) MZL are limited. METHODS: This retrospective panel-based chart review study examined patient characteristics and treatment patterns among patients with R/R MZL who received a second or third line (2L or 3L) of therapy between 1 January 2014 and 31 December 2021 in 7 countries. Treatment patterns were summarized overall and by MZL type. RESULTS: The study included 526 patients, 513 with 2L and 13 with 3L as index treatment. The median age of 2L patients was 67.0 years. Most patients had stage III or IV disease and intermediate or high-risk prognostic scores. Around 60.0% of the patients had nodal, 22.8% had splenic, and 14.2% had mucosa-associated lymphoid tissue (MALT) MZL. Most patients received chemoimmunotherapy (42.8%), Bruton's tyrosine kinase inhibitors (BTKi; 25.1%), or lenalidomide and rituximab/obinutuzumab (16.3%) in 2L. Treatment patterns varied across subtypes, with notable differences in 2L BTKi use. CONCLUSIONS: These findings suggest variability and limitations in the treatment selection for R/R MZL beyond frontline therapy, with the choice of treatment mostly limited to chemoimmunotherapy and BTKi. This study provides much-needed real-world evidence that can help guide clinical management and the development of novel therapies.