Immunotherapy for lymphoma is gaining popularity as a safe and effective way of improving lymphoma treatment outcomes. Here, your immune cells are enhanced. Immunotherapy is the strategy where scientists ‘train’ your immune cells to work in a smarter way to treat the target cancer.
The two types of lymphoma that are treated using immunotherapeutic approaches are mainly Hodgkin’s lymphoma and non-Hodgkin’s lymphoma alongside other subsets. There are three types of immune products that are used as immunotherapy for different subsets of lymphoma patients.
Most of these products are used after first-line interventions like surgery, chemotherapy, and radiotherapy to improve survival rates. Research is still ongoing with many other types of immunotherapeutic products at different stages of development.
I would like to offer some advice to you before I continue. This article is not equivalent to a prescription sheet for immunotherapy. It is meant to give you information so you are better prepared to discuss cancer treatment options with your doctor.
Let’s now discuss the three types of immunotherapy products including the monoclonal antibodies or drug-conjugates of the same, immune checkpoint inhibitors, and adoptive cell therapy (ACT):
Monoclonal Antibodies as Immunotherapy for Lymphoma
Mogamulizumab
This is a monoclonal antibody that targets the CCR4 pathway. This means that once used the blocking of CCR4 on the lymphoma will slow its activities and the patient will get better. It is indicated for non-Hodgkin’s lymphoma particularly Sezary syndrome and mycosis fungoides.
These types of lymphoma can greatly affect your skin. However, by blocking the CCR4 pathway, there is a better prognosis for patients and improved survival. The brand name for this immunotherapeutic product is Poteligeo®.
Rituximab
This is yet another monoclonal antibody that targets blocking CD20 which effectively blocks the CD20 pathway interfering with the ability of lymphoma to spread.
Therefore, the patients who use this product have a better prognosis and subsequently improved survival. Its brand name is Rituxan® and is found in the markets in the US and in other places in the world sometimes.
Obinutuzumab
This is a monoclonal antibody raised to block CD20. Once blocked the CD20 pathway seizes to facilitate lymphoma pathogenesis. This product is used in some places of the world as the first-line treatment for non-Hodgkin’s lymphoma. The brand name for this mAb is Gazyva®.
Tafasitamab-cxix
This is a monoclonal antibody that is raised to block CD19 which is upregulated on the surface of lymphoma cells. This product is indicated for the treatment of diffuse large B cell lymphoma.
Patients when put under this immunotherapeutic product have their disease outcome greatly modified for the better. The brand name of this product is Monjuvi®. The product is found in the US market and in other western countries.
Loncastuximab tesirine
This immunotherapeutic product is made by conjugating a monoclonal antibody and a drug for lymphoma. The resulting product targets the CD19 pathway which slows the metastasis of lymphoma and improves the survival of patients.
It has been used to successfully treat patients with relapsed large B cell lymphoma. The brand name of this product is Zynlonta® and is mostly available in the US markets though with proper arrangements it can be delivered anywhere in the world.
Ibritumomab tiuxetan
This product blocks the CD20’s pathway. Note that CD20 is a critical marker for the spread of lymphoma. This immunotherapeutic product is used to treat some patients with Hodgkin’s lymphoma. It’s available mostly in the US. Its brand name is Zevalin®.
Brentuximab vedotin
This is a monoclonal antibody that is conjugated with a drug to treat both Hodgkin’s and non-Hodgkin’s lymphoma. Other types of cancers treated with this product are systemic large cell lymphoma, peripheral T-cell Lymphomas, and primary cutaneous Anaplastic Large Cell Lymphoma.
This immunotherapeutic product targets CD30 which is an important marker in lymphoma. What this means is that all the types of cancers listed above express CD30.
Polatuzumab vedotin
This product is a hybrid between a drug used in the treatment of lymphoma and a monoclonal antibody. This product works by blocking the CD79b pathway thereby causing slow metastasis of lymphoma.
The product has proven helpful in some patients with non-Hodgkin’s lymphoma. Its brand name is Polivy® and is found in limited markets in western countries including the US.
Checkpoint Inhibitors as Immunotherapy for Lymphoma
Interferon alfa-2b
This product was approved by FDA for the treatment of follicular lymphoma. It is a type of cytokine that targes the interferon-alpha receptor 1/2 pathway blocking it. Interferon alpha-2b is an important factor in lymphoma development.
This improves the prognosis in patients with follicular lymphoma. As expected such improvement has a positive impact on the years of survival of patients. The brand name of this product is Intron A®.
Nivolumab
This is an immune checkpoint inhibitor that contains monoclonal antibodies and targets to block the PD-1/PD-L1 pathway. Checkpoints are very important in a normal immune response as they downregulate it.
However, when cancer sets in, there is a need to block these immune checkpoints to boost the immune response against cancerous cells. This checkpoint inhibitor is used to treat those suffering from Hodgkin’s lymphoma and is available with the brand name Opdivo®.
Pembrolizumab
This product is a checkpoint inhibitor that is used to treat people with Hodgkin’s lymphoma. This product has been approved by FDA and trades with the brand name Keytruda®. It works by blocking the PD-1 pathway boosting the immune response against lymphoma.
Adoptive Cell Therapy as Immunotherapy for Lymphoma
Adoptive cell therapy is a type of immunotherapeutic treatment for cancer. In this type of immunotherapy, immune cells like lymphocytes that have been proven to have a direct effect on cancer are administered. These could be cells with modified receptors to make them more effective.
Examples of adoptive cell therapy strategies include the use of T cells with chimeric antigen receptor (CAR) popularly known as CAR T cell therapy. Another strategy is the use of modified T cell receptors for some types of blood cancers where the target is the tumor-associated antigens (TAAs) overexpressed in these types of cancers.
Let’s now discuss a few FDA-approved products that you can access in the market:
Axicabtagene ciloleucel
This is an FDA-approved immunotherapeutic product. This product is a T lymphocyte with a chimeric antigen receptor (CAR) targeting CD19. The CAR T cells enhance an immune response making other players of the immune system work better.
Remember CD19 is a protein that is overexpressed in non-Hodgkin’s lymphoma as well as in follicular lymphoma. It trades in the market with the name Yescarta®. It has been associated with increased survival of lymphoma patients.
Lisocabtagene maraleucel
This is another product that is targeted against the CD19 markers. It is basically a CAR T cell treatment that was approved by the FDA for the treatment of patients suffering from large B cell lymphoma.
You can access this product in the market with the brand name Breyanzi®. It results in an improved prognosis for patients with lymphoma. Consequently, survival rates have also been shown to improve following the use of this product.
Brexucabtagene autoleucel
This immunotherapy product targets CD19 where a CAT T cell is used for an enhanced immune response that ultimately leads to the destruction of the lymphoma cells.
This product which trades with the brand name Tecartus™ was approved by FDA for the treatment of mantle cell lymphoma. Many doctors have associated this product with improved outcomes so far.
Tisagenlecleucel
This immunotherapeutic product which is a CAR T cell has proven valuable in treating patients with refractory or relapsed large B cell lymphoma. That means that these patients may have been treated using first-line intervention like chemotherapy.
The product is made to target the CD19 marker which is overexpressed in large B cell lymphoma and plays a critical role in pathogenesis. It is available in the market and trades with the brand name Kyrmriah®.
Conclusion
There are three types of products used as immunotherapy for lymphoma. The three are monoclonal antibodies, checkpoint inhibitors, and adoptive cell therapy. All of these have been proven to improve immune response in different subsets of lymphoma patients. They have further shown the ability to improve the prognosis of lymphoma treatment.
Helpful in understanding immunology
Thanks a lot….keep reading James