Choosing Between Tazemetostat and Zanubrutinib+Obinutuzumab: Key Factors & Patient Conversations

EP: 1.Overview of R/R FL: Focus on the 3rd-Line Setting and Beyond START

EP: 2.Managing 3rd-Line R/R FL: Recognizing Progression, Performing Rebiopsies, and Rechecking for CD20 Positivity

EP: 3.Aligning Treatment Goals in R/R FL: Physician vs Patient Perspectives

EP: 4.Clinical Scenario: A 73-Year-Old Patient With R/R FL Requires Treatment in the Third-Line Setting

EP: 5.Expert Perspectives: Tazemetostat in R/R FL

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EP: 6.Choosing Between Tazemetostat and Zanubrutinib+Obinutuzumab: Key Factors & Patient Conversations

Summary for Physicians:

When considering zanubrutinib in combination with obinutuzumab as a treatment option, compared with other regimens, it's important to evaluate several patient- and disease-related factors. These factors include:

• Patient comorbidities: Zanubrutinib is generally well-tolerated, but its use should be carefully considered in patients with cardiovascular issues, as it can cause atrial fibrillation in some cases. Obinutuzumab, being an anti-CD20 monoclonal antibody, may be associated with infusion-related reactions, so patients with a history of such reactions may need closer monitoring.
• Disease characteristics: Zanubrutinib is commonly used for patients with chronic lymphocytic leukemia or marginal zone lymphoma. Its efficacy in these populations and its favorable pharmacokinetics (long half-life and sustained Bruton tyrosine kinase [BTK] inhibition) make it a strong option.
• Previous treatments: For patients for whom other therapies (such as ibrutinib) have failed, zanubrutinib may be a good alternative due to its more selective BTK inhibition and a lower incidence of off-target effects.

When discussing these regimens with patients, it’s important to emphasize the differences in adverse-effect profiles and administration schedules. Zanubrutinib offers a daily oral regimen, which can be more convenient for some patients compared with infusion-based therapies such as obinutuzumab. However, you should also highlight potential adverse effects such as bleeding risks, infections, and the possibility of atrial fibrillation with zanubrutinib. Ultimately, patient preference, tolerability, and specific disease characteristics should guide the decision between these 2 regimens.