tislelizumab + zanubrutinib + rituximab + lenalidomide

This combination therapy is a four-drug regimen consisting of the PD-1 inhibitor tislelizumab, the BTK inhibitor zanubrutinib, the anti-CD20 monoclonal antibody rituximab, and the immunomodulatory agent lenalidomide. It is currently being evaluated in a Phase II clinical trial led by The First Affiliated Hospital with Nanjing Medical University for the treatment of relapsed or refractory follicular lymphoma. The regimen, often referred to as ZR² in combination with tislelizumab, is designed to target multiple pathways in B-cell malignancies: rituximab depletes CD20-positive B cells, zanubrutinib inhibits B-cell receptor signaling via BTK, lenalidomide modulates the immune microenvironment and induces tumor cell apoptosis through cereblon, and tislelizumab restores T-cell anti-tumor activity by blocking the PD-1/PD-L1 checkpoint. This multi-pronged approach aims to improve response rates and durability in patients who have failed prior systemic therapies.

Other names

tislelizumab + zanubrutinib + rituximab + lenalidomide