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Lymphoma

Beyond Monoclonal Antibodies: New Therapeutic Agents in Non-Hodgkin's Lymphomas

Oncology Institute of Southern Switzerland, Ospedale S. Giovanni, Bellinzona, Switzerland

Key Words. Non-Hodgkin's lymphoma • New drugs • Targeted therapies • Molecular pathways

Correspondence: Angelo Delmonte, M.D., Oncology Institute of Southern Switzerland, Ospedale S. Giovanni, 6500 Bellinzona, Switzerland. Telephone: 41918118129; Fax: 41918119044; e-mail: angelo.delmonte{at}eoc.ch

Received September 29, 2008; accepted for publication March 17, 2009; first published online in THE ONCOLOGIST Express on May 1, 2009.

Disclosures

Angelo Delmonte: None; Michele Ghielmini: None; Cristiana Sessa: None.

Section editor George P. Canellos has disclosed no financial relationships relevant to the content of this article.

The article discusses unlabeled, investigational, or alternative use(s) of a product, device or technique; the drugs described in the article are not yet registered. The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias.

The availability of active monoclonal antibodies, either as single agents or in combination with cytotoxic agents, has improved treatment results in non-Hodgkin's lymphoma (NHL).

Despite this and the increasing number of available active monoclonal antibodies, alone or conjugated with radioisotopes, not all types of lymphoma are sensitive to these biological agents and often they become resistant because of different molecular mechanisms.

New molecular targets in neoplastic cells are emerging and provide the rationale for novel discovery initiatives. In fact, a greater knowledge of the biology of lymphoma and the identification of compounds selectively active against a potential therapeutic pathway have already improved the time to progression and survival time of patients with some subtypes of NHL. The growing list of new drugs provides the exciting prospect of developing disease-specific and even patient-specific therapies.

The aim of this review is to identify and discuss non–monoclonal antibody new therapeutic agents in terms of mechanism of action and clinical results. The preclinical and clinical features of proteasome inhibitors, histone deacetylase inhibitors, thalidomide and lenalidomide, mammalian target of rapamycin inhibitors, antisense oligonucleotides, heat shock protein inhibitors, protein kinase C inhibitors, antiangiogenic agents, and new cytotoxics are reviewed.