奥妥珠单抗治疗滤泡性淋巴瘤。
Obinutuzumab in follicular lymphoma.
作者信息
Martinez-Calle N, Figueroa-Mora R, Villar-Fernandez S, Marcos-Jubilar M, Panizo C
机构信息
Department of Hematology, Clínica Universidad de Navarra, Pamplona, Navarra, Spain.
出版信息
Drugs Today (Barc). 2016 Dec;52(12):643-651. doi: 10.1358/dot.2016.52.12.2550578.
The CD20 marker continues to be exploited as a therapeutic target for non-Hodgkin's lymphoma. Obinutuzumab is part of a new generation of anti-CD20 monoclonal antibodies, which are synthesized using molecular engineering technology, resulting in novel target epitopes and unprecedented optimization of antibody-dependent cellular cytotoxicity and antibody-dependent cellular phagocytosis. Rituximab is the current gold standard for anti-CD20 therapy, yet despite outstanding results published over the past decade, many patients continue to relapse after anti-CD20 regimens. Obinutuzumab is slowly positioning itself in the treatment of CD20+ B-cell neoplasms. On the basis of favorable results from the phase III GADOLIN trial, obinutuzumab was recently approved by the U.S. Food and Drug Administration in combination with bendamustine followed by obinutuzumab maintenance, for the treatment of follicular lymphoma (FL) patients who relapsed or are refractory to a rituximab-containing regimen. Additional phase III trials are underway to test obinutuzumab as a first-line anti-CD20 agent in FL with good preliminary results (GALLIUM trial); thus, it is likely that obinutuzumab will soon achieve a first-line indication. It is plausible that obinutuzumab will replace rituximab as the gold standard for chemoimmunotherapy in FL, although some safety concerns still need to be resolved. This review will address the preclinical pharmacology and the main aspects of the clinical development of obinutuzumab for the treatment of FL.
CD20标志物仍然是治疗非霍奇金淋巴瘤的一个靶点。奥滨尤妥珠单抗是新一代抗CD20单克隆抗体的一部分,这些抗体采用分子工程技术合成,产生了新的靶表位,并使抗体依赖性细胞毒性和抗体依赖性细胞吞噬作用得到了前所未有的优化。利妥昔单抗是目前抗CD20治疗的金标准,然而,尽管在过去十年中公布了出色的结果,但许多患者在接受抗CD20治疗方案后仍会复发。奥滨尤妥珠单抗正在逐渐在CD20+B细胞肿瘤的治疗中占据一席之地。基于III期GADOLIN试验的良好结果,奥滨尤妥珠单抗最近被美国食品药品监督管理局批准,与苯达莫司汀联合使用,随后进行奥滨尤妥珠单抗维持治疗,用于治疗对含利妥昔单抗方案复发或难治的滤泡性淋巴瘤(FL)患者。其他III期试验正在进行,以测试奥滨尤妥珠单抗作为FL一线抗CD20药物的疗效,初步结果良好(GALLIUM试验);因此,奥滨尤妥珠单抗很可能很快获得一线适应症。奥滨尤妥珠单抗有可能取代利妥昔单抗成为FL化疗免疫治疗的金标准,尽管一些安全性问题仍需解决。本综述将阐述奥滨尤妥珠单抗治疗FL的临床前药理学及临床开发的主要方面。