New agents in development for non-Hodgkin's lymphoma

Since its introduction 10 years ago, the anti-CD20 monoclonal antibody rituximab has benefited numerous patients with non-Hodgkin's lymphoma (NHL). However, rituximab is not effective in all patients, and many patients who initially respond ultimately develop resistance. Several strategies have been implemented to improve upon the efficacy of rituximab, including radiolabeled anti-CD20 antibodies, second-generation engineered anti-CD20 antibodies with various potential improvements over rituximab, and novel monoclonal antibodies directed against other B-cell antigens. This review describes results from early clinical trials in lymphoma patients for many of these new agents, including the anti-CD20 antibodies ofatumumab and hA20, the anti-CD22 antibodies epratuzumab and CIVIC-544, the anti-CD80 antibody galiximab, and the anti-CD40 antibody SGN-40. These therapies are promising, and many are currently being evaluated with rituximab in clinical trials to determine the optimal combination therapies for lymphoma patients.