Novo Mattia, Santambrogio Elisa, Frascione Pio Manlio Mirko, Rota-Scalabrini Delia, Vitolo Umberto
Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute, FPO-IRCCS, Torino, Italy.
Hematology Unit, Santa Croce e Carle Hospital, Cuneo, Italy.
Biologics. 2021 May 18;15:153-174. doi: 10.2147/BTT.S281618. eCollection 2021.
Large B-cell lymphomas (LBCLs) constitute a subgroup of aggressive but highly curable lymphoproliferative diseases. Treatment of relapsed/refractory (R/R) patients still represents an unmet clinical need, and novel drugs and combinations are in continuous development. The pan-B cell panel of surface antigens that characterizes LBCL leads to a large umbrella of druggable targets. Monoclonal antibodies (mAbs) express their activity against lymphoma by targeting multiple tumor-specific antigens. This category consists of a number of molecules with different mechanisms of action, including naked mAbs, radioimmunoconjugates, antibody-drug conjugates, checkpoint inhibitors, and bispecific antibodies. In the last decade, apart from the well-known role of the anti-CD20 mAb rituximab, novel mAbs have led to remarkable steps forward in the treatment of R/R LBCL in monotherapy and combined with chemotherapy. Multiple studies are in development trying to bring these novel compounds into the frontline setting to empower the RCHOP effect or as alternative chemotherapy-free options for elderly/unfit patients. This review provides insight into antilymphoma mAbs, focused on the efficacy and safety of the main molecules approved or in development for LBCL andperspectives on the treatment of this disease.
大B细胞淋巴瘤(LBCL)是侵袭性但高度可治愈的淋巴增殖性疾病的一个亚组。复发/难治性(R/R)患者的治疗仍然是未满足的临床需求,新型药物和联合方案不断在研发中。表征LBCL的全B细胞表面抗原组导致了大量可成药靶点。单克隆抗体(mAb)通过靶向多种肿瘤特异性抗原发挥其抗淋巴瘤活性。这一类别包括许多具有不同作用机制的分子,包括裸mAb、放射免疫缀合物、抗体-药物缀合物、检查点抑制剂和双特异性抗体。在过去十年中,除了抗CD20 mAb利妥昔单抗的知名作用外,新型mAb在R/R LBCL的单药治疗以及与化疗联合治疗方面取得了显著进展。多项研究正在开展,试图将这些新型化合物引入一线治疗,以增强RCHOP方案的疗效,或作为老年/身体状况不佳患者的无化疗替代方案。本综述深入探讨了抗淋巴瘤mAb,重点关注已获批或正在研发用于LBCL的主要分子的疗效和安全性,以及该疾病治疗的前景。