Abstract
A better understanding of the biology and pathogenesis of hematological malignancies has led to the development of immunotherapeutic and immunoregulatory drugs. Many of these agents have revolutionized the current treatment modalities, while others are under investigation. Rituximab (anti-CD20 antibody) has been established as the gold standard of treatment for aggressive B-cell lymphomas in combination with CHOP and has shown significant activity as monotherapy in the treatment of indolent B-cell lymphomas. In follicular lymphomas the combination of Rituximab with chemotherapy improves the outcome compared to chemotherapy alone. CD 20-based radioimmunotherapy, with the advantage of the bystander effect, represents an additional therapeutic alternative in B-cell lymphomas and may produce tumor regression in Rituximab resistant patients. The anti-CD52 monoclonal antibody, alemtuzumab, further expands the armamentarium against lymphoid malignancies producing high response rates in these entities. Antibody-targeted chemotherapy such as gemtuzumab ozogamicin, consisting of an anti-CD33 antibody combined to calicheamicin, has shown efficacy in the treatment of refractory acute myeloid leukemia; exact indications, timing and dosing schedule for optimized efficacy remain to be determined. Interferons have proven significant activity in cutaneous lymphomas, hairy cell leukemia and chronic myelogenous leukemia by mechanisms that are not fully elucidated. Thalidomide, by acting as an immunomodulatory and antiangiogenic agent can modulate neoplastic cells microenvironment and lead to disease control in multiple myeloma as well as in numerous other hematological malignancies. Bortezomib, a proteasome inhibitor, displays significant anti-tumor activity, especially in multiple myeloma and lymphoproliferative disorders. The addition of these agents in therapeutic regimens has improved considerably the treatment of hematological malignancies.
Keywords: Treatment, Rituximab, Radioimmunotherapy, Alemtuzumab, Gemtuzumab-ozogamicin, Interferons, Thalidomide, Bortezomib
Current Topics in Medicinal Chemistry
Title: Immunotherapeutic and Immunoregulatory Drugs in Haematologic Malignancies
Volume: 6 Issue: 16
Author(s): Gerassimos A. Pangalis, Marie-Christine Kyrtsonis, Theodoros P. Vassilakopoulos, Maria N. Dimopoulou, Marina P. Siakantaris, Christos Emmanouilides, Dimitris Doufexis, Sotirios Sahanas, Flora N. Kontopidou, Christina Kalpadakis, Maria K. Angelopoulou, Evangelia M. Dimitriadou, Styliani I. Kokoris and Panayiotis Panayiotidis
Affiliation:
Keywords: Treatment, Rituximab, Radioimmunotherapy, Alemtuzumab, Gemtuzumab-ozogamicin, Interferons, Thalidomide, Bortezomib
Abstract: A better understanding of the biology and pathogenesis of hematological malignancies has led to the development of immunotherapeutic and immunoregulatory drugs. Many of these agents have revolutionized the current treatment modalities, while others are under investigation. Rituximab (anti-CD20 antibody) has been established as the gold standard of treatment for aggressive B-cell lymphomas in combination with CHOP and has shown significant activity as monotherapy in the treatment of indolent B-cell lymphomas. In follicular lymphomas the combination of Rituximab with chemotherapy improves the outcome compared to chemotherapy alone. CD 20-based radioimmunotherapy, with the advantage of the bystander effect, represents an additional therapeutic alternative in B-cell lymphomas and may produce tumor regression in Rituximab resistant patients. The anti-CD52 monoclonal antibody, alemtuzumab, further expands the armamentarium against lymphoid malignancies producing high response rates in these entities. Antibody-targeted chemotherapy such as gemtuzumab ozogamicin, consisting of an anti-CD33 antibody combined to calicheamicin, has shown efficacy in the treatment of refractory acute myeloid leukemia; exact indications, timing and dosing schedule for optimized efficacy remain to be determined. Interferons have proven significant activity in cutaneous lymphomas, hairy cell leukemia and chronic myelogenous leukemia by mechanisms that are not fully elucidated. Thalidomide, by acting as an immunomodulatory and antiangiogenic agent can modulate neoplastic cells microenvironment and lead to disease control in multiple myeloma as well as in numerous other hematological malignancies. Bortezomib, a proteasome inhibitor, displays significant anti-tumor activity, especially in multiple myeloma and lymphoproliferative disorders. The addition of these agents in therapeutic regimens has improved considerably the treatment of hematological malignancies.
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Pangalis A. Gerassimos, Kyrtsonis Marie-Christine, Vassilakopoulos P. Theodoros, Dimopoulou N. Maria, Siakantaris P. Marina, Emmanouilides Christos, Doufexis Dimitris, Sahanas Sotirios, Kontopidou N. Flora, Kalpadakis Christina, Angelopoulou K. Maria, Dimitriadou M. Evangelia, Kokoris I. Styliani and Panayiotidis Panayiotis, Immunotherapeutic and Immunoregulatory Drugs in Haematologic Malignancies, Current Topics in Medicinal Chemistry 2006; 6 (16) . https://dx.doi.org/10.2174/156802606778194235
DOI https://dx.doi.org/10.2174/156802606778194235 |
Print ISSN 1568-0266 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4294 |
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