Obinutuzumab and Ibrutinib as Front Line Therapy in Treating Patients With Indolent Non-Hodgkin's Lymphomas

Inclusion Criteria

• •Previously untreated, histologically confirmed indolent non-Hodgkin's lymphoma as follows:
• •* Follicular lymphoma (World Health Organization \[WHO\] classification grade 1, 2, or 3a)
• •* Marginal zone lymphoma including:
• •* Nodal and splenic marginal zone lymphoma (MZL) who have an indication for systemic therapy
• •* Extranodal MZL:
• •* Nongastric/noncutaneous MZL requiring systemic therapy
• •* Cutaneous MZL will be eligible only if they have pathologically confirmed extra-cutaneous disease
• •* Gastric MZL only if stage IIIE/IV defined as lymph node involvement on both sides of the diaphragm or with disseminated extranodal disease such as bone marrow or additional extra nodal sites
• •Pathological diagnosis should be obtained by incisional or excisional tissue biopsy; core biopsy is permissible if obtaining an incisional or excisional is not possible and if the grade can be assessed on the core biopsy; a core biopsy can also be used if deemed in the best interest of the patient in the opinion of the investigator
• •Patients must have stage II-IV disease
• •All patients should have measurable disease; measurable disease is defined as a lymph node or tumor mass that is \>= 1.5 cm in at least one dimension by computed tomography (CT) or the CT portion of the PET/CT
• •Documentation of CD20+ status
• •Patients must have an indication for therapy per standard modified Groupe d'Etude des Lymphomes Folliculaires (GELF) criteria including:
• •* Symptoms attributable to lymphoma
• •* B symptoms
• •* Threatened end-organ function
• •* Pleural effusions or peritoneal ascites
• •* Cytopenia secondary to lymphoma
• •* Leukemia
• •* Bulky disease (defined as: Single mass \>7cm in diameter, or 3 or more masses \> 3 cm in diameter)
• •* Splenomegaly
• •* And steady progression over at least 6 months
• •Age \> 18 years
• •Eastern Cooperative Oncology Group (ECOG) performance status 0-2
• •Patients must be able to swallow whole pills
• •Ability and willingness to comply with the requirements of the study protocol; when it is determined by the study investigator that a potential research participant is cognitively impaired, a surrogate consent from a caregiver or legally-authorized representative will be obtained. Caregiver or legally-authorized representative will ensure that they comply with the protocol in order for the subject to be considered eligible
• •Female subjects who are of non-reproductive potential (i.e., post-menopausal by history - no menses for \>= 1 year; OR history of hysterectomy; OR history of bilateral tubal ligation; OR history of bilateral oophorectomy); female subjects of childbearing potential must have a negative urine/serum pregnancy test upon study entry
• •Male and female subjects who agree to use both a highly effective method of birth control (e.g., implants, injectables, combined oral contraceptives, some intrauterine devices \[IUDs\], complete abstinence , or sterilized partner) and a barrier method (e.g., condoms, vaginal ring, sponge, etc) during the period of therapy; female patients of reproductive potential who are not surgically sterile must practice adequate birth control for a minimum of twelve months post-treatment; male patients who are not surgically sterile must practice adequate birth control for a minimum of three months post-treatment
• •Absolute neutrophil count \> 1.5 x 10\^9 cells/mm\^3
• •Platelet count \> 50,000 cells/mm\^3 (50 x 10\^9/L)
• •Hemoglobin \> 9.0 g/dL
• •Serum aspartate transaminase or alanine transaminase =\< 3.0 x upper limit of normal (ULN)
• •Prothrombin time (PT)/international normalized ratio (INR) \< 1.5 x ULN and activated partial thromboplastin time (aPTT) \< 1.5 x ULN (unless abnormalities are unrelated to coagulopathy or bleeding disorder)
• •Estimated creatinine clearance \>= 30 ml/min (calculated according using Cockcroft-Gault formula)
• •Bilirubin =\< 1.5 x ULN (unless bilirubin rise is due to Gilbert's syndrome or of non-hepatic origin)
• •Patients with Child Pugh B or C liver failure will be excluded