How would you manage a patient with marginal zone lymphoma who progress after treatment on a BKTI?

Was the BTKi the first line of therapy? If so, many options remain: 1) anti-CD20 alone if relatively low volume disease, 2) BR/BO, or 3) Len-rituximab. I guess one could now consider Len-ritux-tafa based on InMIND, but marginal zone enrollment was small and the schedule is not easy.

The above options are adequate, but in my opinion, the best option is cladribine + rituxan or obinutuzumab. See my review article from the past. We need trials, but this treatment can produce high response rates with extended remissions and possible cures.