Management of central nervous system lymphomas using monoclonal antibodies: challenges and opportunities.
Monoclonal antibodies (mAb) may change the management of central nervous system (CNS) lymphomas. This is due to the fact that traditional chemotherapies lack specificity for B-lymphoma cells and blood-brain barrier prevents adequate chemotherapy dosing in the CNS without significant systemic side effects. But in the past 5 years, the emergence of mAbs against specific receptors on B-lymphoma cells, either as a single agent or in combination with cytotoxic chemotherapies, may offer a better therapeutic index than conventional chemotherapies. The advantages of mAbs include high affinity to targets on lymphoma cells, their lack of pharmacodynamic or pharmacokinetic interactions with other drugs, and a potential for a synergistic therapeutic response when combined with conventional chemotherapies. Our review summarizes the biological behaviors of CNS lymphomas and the challenges and opportunities in using mAbs for CNS lymphomas.
Wong
Eric T
ET
Department of Neurology and Neuro-Oncology Unit, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. ewong@bidmc.harvard.edu
D000368:Aged; D000911:Antibodies, Monoclonal / Q000737:chemistry / Q000627:therapeutic use*; D001812:Blood-Brain Barrier / Q000378:metabolism; D016543:Central Nervous System Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D005682:Gadolinium / Q000494:pharmacology; D005910:Glioma / Q000473:pathology; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008223:Lymphoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D016393:Lymphoma, B-Cell / Q000276:immunology; D008875:Middle Aged; D016719:Radioimmunodetection / Q000379:methods; D016499:Radioimmunotherapy / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D005682:Gadolinium