Novel and Engineered Anti–B-Cell Monoclonal Antibodies for Non-Hodgkin’s Lymphoma

Over the past decade, the safety and efficacy of the anti-CD20 antibody rituximab has resulted in its use in virtually all patients with B-cell non-Hodgkin’s lymphoma (NHL). Unfortunately, many patients who initially benefit from rituximab develop resistance while others may never respond. Both the successes and limitations of rituximab have heralded an explosion in research and development of novel monoclonal antibodies. Strategies employed to improve upon rituximab have included developing antibodies to target new epitopes of CD20 and new antigens, humanizing or creating fully human antibodies, and engineering antibodies with a potentially greater capacity for interaction with the host immune system. Each of these strategies has shown varying degrees of preclinical and clinical success. In this review we discuss the rationale for various strategies and report results from clinical trials employing these agents.