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This combination regimen, often referred to as ZBG, consists of the Bruton's tyrosine kinase (BTK) inhibitor zanubrutinib, the alkylating agent bendamustine, and the anti-CD20 monoclonal antibody obinutuzumab. It is being investigated as a fixed-duration, frontline treatment for patients with advanced-stage follicular lymphoma. Zanubrutinib provides targeted inhibition of B-cell receptor signaling by covalently binding to BTK. Bendamustine induces cell death through DNA cross-linking and interference with DNA replication. Obinutuzumab targets CD20-positive B-cells, promoting direct cell death and immune-mediated clearance via antibody-dependent cellular cytotoxicity (ADCC) and complement-dependent cytotoxicity (CDC). The regimen aims to provide a potent, time-limited therapy to achieve deep responses, including MRD negativity, without the need for long-term maintenance.
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