What is the role of monoclonal antibodies in the treatment of non-Hodgkin lymphoma/B-cell lymphoma?

Updated: Feb 23, 2021
  • Author: Mohammad Muhsin Chisti, MD, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Polatuzumab vedotin-piiq (Polivy) is an FDA-approved anti-CD79b antibody drug indicated for multiply relapsed or refractory DLBCL. A clinical trial has shown longer duration of remission when polatuzumab is added to bendamustine and rituximab. Common reported adverse effects include progressive multifocal leukoencephalopathy (PML), peripheral neuropathy, tumor lysis syndrome and fetal toxicity. [24, 25]

Other monoclonal antibodies undergoing phase 2 clinical trials include the following:

  • Brentuximab vedotin 
  • Blinatumomab 
  • Tafasitamab 

Mosunetuzumab is the newest monoclonal antibody; it binds to CD3 and CD20. A phase 1/2 clinical trial showed long-lasting responses with a very tolerable safety profile in patients with B-cell non-Hodgkin lymphoma (NHL) who had received at least 1 prior therapy, who had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, and for whom there was no available therapy that would be expected to improve survival. Compared with patients who had already progressed despite CAR T-cell therapy, patients treated with mosunetuzumab showed better response (objective response rate 37%,complete remission 22%). Common adverse reaction included cytokine release syndrome, headache, and insomnia. [26]


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