Where marginal zone lymphoma treatment is heading

About 8,000 people in the US are diagnosed with marginal zone lymphoma each year. It is a slow-growing B-cell lymphoma that can arise in the stomach or other organs (MALT lymphoma), the spleen, or lymph nodes, and some cases are linked to chronic infections. Many people need little or no treatment for years. When treatment is needed, rituximab, chemotherapy, BTK inhibitor pills and now CAR T cells and bispecific antibodies are options.

• 140studies open or running
• 10phase 3 trials
• 233papers published this year

1. Now

   Nov 2026

   The first CAR T-cell therapy for marginal zone lymphomaHappened 95% response rate

   Liso-cel produced responses in 95% of heavily treated people; approved December 2025.

   95%: overall response rate.

   • TRANSCEND FL, marginal zone cohort

   Pill combinations clear more diseaseHappened 57% complete response

   Ibrutinib plus venetoclax: 57% complete responses vs 3% historically with ibrutinib alone.

   57%: best complete response rate, vs 3% historically with ibrutinib alone.

   • Ibrutinib plus venetoclax study

   An option after BTK inhibitorsHappened 55.6% response rate

   Pirtobrutinib worked in 55.6% of heavily treated people, including after other BTK pills.

   55.6%: response rate.

   • BRUIN study, marginal zone cohort

2. 6 months

   by May 2027

   Bispecific antibodies tested at relapsePossible

   A LYSA trial (260 people) compares mosunetuzumab plus lenalidomide with standard choices; due September 2027.

   • LYSA mosunetuzumab trial

3. 12 months

   by Nov 2027

   A BTK pill combination vs R2Possible

   MAHOGANY (799 people, follicular and marginal zone lymphoma) compares zanubrutinib plus obinutuzumab with R2; due July 2028.

   • MAHOGANY

4. 3 years

   by late 2029

   Adding a BTK pill to first treatmentPossible

   RITZ (122 people) adds zanubrutinib to rituximab for untreated disease; due May 2029.

   • RITZ

   Lower-dose radiationPossible

   A Memorial Sloan Kettering trial (375 people) tests very-low-dose radiation for slow-growing B-cell lymphomas; due June 2028.

   • Low-dose radiation trial

5. 5 years

   by late 2031

   A bispecific with lenalidomideLong shot

   Regeneron's OLYMPIA-5 (580 people) compares odronextamab plus lenalidomide with R2; due April 2031.

   • OLYMPIA-5

   Bispecific combinations in the USLong shot

   A SWOG trial will test mosunetuzumab alone or with zanubrutinib or polatuzumab.

   • SWOG mosunetuzumab trial

The research paths

Borrowed from other cancers

Open to join now

• Relapsed

  Mosunetuzumab plus lenalidomide

  Phase 3 · 48 sites

  Locations and eligibility →

• Relapsed

  Odronextamab plus lenalidomide

  Phase 3 · 172 sites

  Locations and eligibility →

• Relapsed

  Orelabrutinib plus rituximab

  Phase 3 · 19 sites

  Locations and eligibility →

• Localized B-cell lymphoma

  Very-low-dose radiation

  Phase 3 · 7 sites

  Locations and eligibility →

See every recruiting Marginal zone lymphoma trial →

When the trials finish

Completion dates the trials registered. Results usually follow 3 to 12 months later.

What just happened

Standard treatment today

• Stomach MALT lymphoma with H. pyloriAntibiotics to clear the infection, which cures many early cases.
• LocalizedLow-dose radiation.
• Advanced, needs treatmentRituximab alone or with chemotherapy (bendamustine); BTK inhibitors.
• RelapsedBTK inhibitors (zanubrutinib), R2 (lenalidomide-rituximab), pirtobrutinib, liso-cel CAR T cells.

See Marginal zone lymphoma trials recruiting now →