Sarraf Yazdy Maryam, Cheson Bruce D
Division of Hematology-Oncology, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC, USA,
Blood Lymphat Cancer. 2017 Oct 19;7:73-83. doi: 10.2147/BLCTT.S114173. eCollection 2017.
Although rituximab-based chemoimmunotherapy prolongs the survival of patients with follicular lymphoma (FL), this disease is considered incurable in most patients. Thus, new therapies are needed not only for those in the relapsed/refractory setting, but also for initial treatment. Obinutuzumab (G, GA101) is a third-generation, fully humanized type II glycoengineered, anti-CD20 monoclonal antibody that results in increased direct cell death and antibody-dependent, cell-mediated cytotoxicity/phagocytosis compared to rituximab. Obinutuzumab has significant antitumor activity when used alone or in combinations in untreated or relapsed refractory FL patients. Studies have demonstrated its ability to prolong progression-free survival and, in some cases, overall survival, and to eliminate minimal residual disease. Several ongoing trials are investigating combinations with chemotherapy, immunomodulators, targeted drugs, and immunotherapy agents. G is generally well tolerated, with associated adverse effects including infusion-related reactions, neutropenia, thrombocytopenia, and reactivation of hepatitis B virus. Future studies with this antibody should focus on identifying predictive markers and developing chemotherapy-free combinations that will improve the outcome of patients with FL.
尽管基于利妥昔单抗的化疗免疫疗法可延长滤泡性淋巴瘤（FL）患者的生存期，但大多数患者的这种疾病仍被认为无法治愈。因此，不仅复发/难治性患者需要新的治疗方法，初始治疗患者也需要。奥妥珠单抗（G，GA101）是一种第三代、完全人源化的II型糖基工程化抗CD20单克隆抗体，与利妥昔单抗相比，它可增加直接细胞死亡以及抗体依赖性细胞介导的细胞毒性/吞噬作用。奥妥珠单抗单独使用或与其他药物联合用于未治疗或复发难治性FL患者时具有显著的抗肿瘤活性。研究已证明其具有延长无进展生存期的能力，在某些情况下还能延长总生存期，并能清除微小残留病灶。几项正在进行的试验正在研究其与化疗、免疫调节剂、靶向药物和免疫治疗药物联合使用的情况。G通常耐受性良好，相关不良反应包括输注相关反应、中性粒细胞减少、血小板减少以及乙肝病毒再激活。对这种抗体的未来研究应集中于确定预测标志物以及开发无化疗联合方案，以改善FL患者的治疗结果。
