Anti-Cd20 Antibody Treatment for B-Cell Malignancies Publisher



Abubakar SD^{1, 2} ; Ihim SA^{3, 4} ; Aliyu M^{5, 6} ; Saffarioun M⁷ ; Azizi G^{8, 9} Show Affiliations
Source: Resistance to Anti-CD20 Antibodies and approaches for their Reversal: Volume 2 Published:2023

Abstract

B-cell malignancies account for the majority of non-Hodgkin’s lymphomas and approximately 2.8% of all cancer cases. CD20 is a prominent surface marker molecule expressed in most stages of B-cell development. The observation of the high expression of CD20 on many B-cell neoplasms led to its utility as a target for cancer management. Many monoclonal anti-CD20 antibodies were licensed and some were being researched; they employ varying degrees of the antibody-mediated killing of their target, which includes antibody-dependent cell-mediated cytotoxicity (ADCC), antibody-dependent cell-mediated phagocytosis (ADCP), complement-dependent cytotoxicity (CDC), induction of apoptosis, direct cell death, increased expression of reactive oxygen species, and other nonapoptotic cell death mechanisms. Rituximab, an anti-CD20 monoclonal antibody, was the first FDA-approved CD20-based agent for cancer management with huge success. However, there exist some poor outcomes among some patients and in certain B-cell cancer types. Despite anti-CD20 combination therapy with chemotherapy and radiotherapy in B-cell non-Hodgkin’s lymphoma, refractory cases arise, which were thought to be caused by mutations in CD20 signaling pathways. Currently, combining anti-CD20 with other monoclonal antibodies has yielded promising results in some B-cell neoplasms. In this chapter, we carefully scrutinized and reviewed the most recent classification of B-cell malignancies and available anti-CD20-based agents. We discussed the origin, mechanism of action, efficacy, and side effects of CD20-based agents in the management of B-cell malignancies. We also show how these shortcomings could be remedied from knowledge obtained from recent advances in molecular, genomic, and clinical studies. © 2024 Elsevier Inc. All rights reserved.