Targeted treatments and antibody therapy
Targeted treatments, including antibody therapies, are medicines that have been designed to ‘target’ cancer cells. Targeted treatments and antibody therapies can be used to treat lymphoma.
We have separate information on the specific drugs used to treat lymphoma.
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What are targeted treatments?
Targeted treatments are medicines that have been specially designed to attack particular proteins on lymphoma cells. The proteins they attack are much more common in lymphoma cells than in healthy cells. They are often proteins that are important in helping the cancer cells grow and survive.
Targeted treatments attack lymphoma cells more precisely than chemotherapy. This means they are able to kill lymphoma cells with fewer effects on healthy cells, leading to potentially fewer side effects.
Types of targeted treatment
There are lots of different types of targeted treatment, depending on the protein they attack.
Some targeted treatments are given on their own. Some targeted treatments are given alongside antibody therapy or chemotherapy.
Here, we give a brief overview of the main types that are available to treat lymphoma. We have more information on the individual drugs, including the exact types of lymphoma they are used to treat – click on the drug name to go to it.
B-cell receptor pathway inhibitors
All cells use chemical messengers to send and receive signals to and from other cells. Some of these signals keep the cells alive or make them divide. B-cell receptor pathway inhibitors block these signals in B cells – the cells that grow out of control if you have a B-cell lymphoma. Blocking the signals can make the B cells die or stop them dividing.
There are different types of B-cell receptor pathway inhibitors, depending on the protein they block.
BTK inhibitors
BTK inhibitors block a protein called Bruton’s tyrosine kinase (BTK). BTK plays a crucial role in B cell development. BTK inhibitors currently available to treat some types of lymphoma are:
PI3K inhibitors
PI3K inhibitors block a protein called phosphatidylinositol 3-kinase (PI3K). PI3K is involved in cell growth and survival. The PI3K inhibitor currently available to treat CLL/SLL is:
BCL-2 inhibitors
Cells usually have a natural lifespan. When they get old, they die and are replaced by new cells.
B-cell lymphoma-2 (BCL-2) is a protein that can block the natural process that makes cells die when they should. Some lymphoma cells make a lot more BCL-2 than healthy cells, which helps them stay alive longer than they should. BCL-2 inhibitors block the BCL-2 protein. This activates the process of natural cell death.
The BCL-2 inhibitor currently available to treat CLL/SLL is:
Checkpoint inhibitors
Some lymphoma cells are able to hide from your immune system by sticking to a protein on T cells that tells the T cell not to attack. Checkpoint inhibitors block this protein. This means your T cells are able to recognise and attack the lymphoma cells.
Checkpoint inhibitors that are currently available to treat some types of lymphoma are:
Proteasome inhibitors
Proteasomes are chemicals that break down proteins inside cells and recycle them. This helps keep the proteins in balance so the cell works as it should. It is a natural process – but it is especially important for lymphoma cells because they make a lot more protein than healthy cells. Proteasome inhibitors block proteasomes, which leads to a build-up of proteins in the lymphoma cells. This means the cells are no longer able to work properly and die.
The proteasome inhibitor currently available to treat some types of lymphoma is called:
Immunomodulators
Immunomodulators are drugs that alter the way your immune system responds to lymphoma cells, helping it work more effectively. They also act directly on lymphoma cells to stop the cells dividing, and activate processes that kill the cells.
The immunomodulator currently available to treat some types of lymphoma is called:
What is antibody therapy?
Antibody therapy is a type of targeted treatment.
Antibodies are specialised proteins made by your white blood cells. They help fight infections by sticking to proteins on the surface of cells that don’t belong in your body, such as viruses and bacteria. Once they have stuck to these proteins, the antibodies either kill the cell directly or help your immune system to find it and destroy it.
Antibody therapy uses antibodies that have been specially made in a lab. They are designed to recognise and stick to a protein on a cancer cell. This activates your immune system to destroy the cancer cell. Antibody therapy is also known as ‘immunotherapy’ because it works through your own immune system.
Antibody therapy is often given alongside chemotherapy. This is called ‘chemoimmunotherapy’ (or CIT).
Types of antibody therapy
There are different types of antibody therapy available to treat lymphoma. They work in different ways depending on how they are made and the proteins they target. Here, we give a brief overview of the main types available to treat lymphoma. We have more information on the individual drugs, including the exact types of lymphoma they are used to treat – click on the drug name to go to it.
Monoclonal antibodies
‘Monoclonal’ antibodies means that all the antibodies are exactly the same, so they stick to exactly the same protein. When they stick to their target protein, they activate your immune system to destroy the cell that’s making the protein.
There are different monoclonal antibodies available to treat lymphoma that target different proteins. These include:
- rituximab, which sticks to a protein called CD20 on B-cell lymphomas
- obinutuzumab, which sticks to a protein called CD20 on B-cell lymphomas
- mogamulizumab, which sticks to a protein called CCR4 on T-cell lymphomas.
Antibody–drug conjugates
Antibody–drug conjugates are monoclonal antibodies joined to a small dose of a chemotherapy drug. The antibody is designed to stick to a protein on lymphoma cells and carry the chemotherapy drug directly to them. This allows for a more targeted delivery of chemotherapy directly into the lymphoma cells and can result in fewer side effects than standard chemotherapy.
The following antibody–drug conjugates are available to treat some types of lymphoma:
Bispecific antibodies
Most antibody therapies stick to one target protein. Bispecific antibodies stick to two different target proteins – one on lymphoma cells and one on healthy T cells (immune cells that can kill other cells). This helps the T cells of your immune system to find and destroy the lymphoma cells.
The following bispecific antibodies are available to treat some types of lymphoma:
Watch our video if you want to know more about new and future treatments for lymphoma. In it, Professor Andy Davies talks about the recent developments in treatment options, including targeted treatments and antibody therapies.