價Check for updatesReceived:10 February 2023 Revised:21 April 2023 Accepted:25 April 2023D0L10.1002/hon.3172REVIEWWILEYUnmet clinical needs in the use of zanubrutinib in malignantlymphomas (Waldenstrom macroglobulinemia,marginal zonelymphoma and mantle cell lymphoma):A consensus-basedposition paper from an ad hoc expert panelPier Luigi Zinzani12 Francesca Romana Mauro3 Alessandra Tedeschi4Marzia Varettoni5 Francesco Zajas7 Giovanni BarosiRCCS Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia'Seragnoli.Bologna,Italy2Dipartimento di Scienze Mediche e Chirurgiche,Universita di Bologna,Bologna,Italy3Hematology.Department of Translational and Precision Medicine,'Sapienza'University.Roma,ItalyDepartment of Hematology.Niguarda Cancer Center.ASST Grande Ospedale Metropolitano Niguarda,Milano.Italy5Division of Hematology.Fondazione IRCCS Policlinico San Matteo,Pavia,ItalyDipartimento Clinico di Scienze Mediche,Chirurgiche e della Salute,Universita degli Studi di Trieste,Trieste,Italy7Unita Complessa Operativa (UCO)Ematologia,Azienda Sanitaria Universitaria Giuliano Isontina,Trieste.ItalyCenter for the Study of Myelofibrosis,IRCCS Polidinico S.Matteo Foundation,Pavia,ItalyCorrespondencePier Luigi Zinzani,IRCCS AziendaAbstractOspedaliero-Universitaria di Bologna IstitutoZanubrutinib has been approved for the treatment of patients with different lym-di Ematologia 'Seragnoli:Dipartimento diScienze Mediche e Chirurgiche,Universita diphoproliferative disorders,and now represents a major breakthrough in the treat-Bologna:Institute of Hematology "Lorenzo ement of patients resistant or relapsing after the recommended therapies.BecauseAriosto Seragnoli',Via Massarenti,9.Bologna40138.taly.few systematic studies or comparative randomized clinical trials have been con-Email:pierluigi.zinzani@unibo.itducted,optimal use of the drug in approved indications is challenging.and questionsare emerging on its use in earlier stages of the disorders.This article presents theresults of group discussion among an ad hoc constituted panel of experts aimed atidentifying and addressing unmet clinical needs(UCNs)in the use of zanubrutinib inthe lymphomas which have received the approval of use,specifically Waldenstrommacroglubulinemia,marginal zone lymphoma and mantle cell lymphoma.Key UCNswere selected according to the criterion of clinical relevance using the Delphi pro-cess.The panel produced recommendations and proposals for new studies for themanagement of the identified UCNs.These recommendations are intended for usenot only by expert centers but above all by not experienced hematologists as well asgeneral practitioners.KEYWORDSmantle cell lymphoma,marginal zone lymphoma,Waldenstrom macroglobulinemia,zanubrutinibHematological Oncology.2023:1-14.wileyonlinelibrary.com/journal/hon2023 John Wiley Sons Ltd.1
