Innovation in non-Hodgkin lymphoma drug discovery: what needs to be done?

ABSTRACT

Introduction: A new generation of anticancer agents called target drugs has been recently developed for the treatment of non-Hodgkin lymphomas. Current recovery rates in these diseases are up to 70% with immunotherapy based on the anti-CD20 monoclonal antibody combined with standard chemotherapeutics. However, there are still refractory or relapsed patients. Recently, several novel anti-lymphoma agents have been developed. Choosing the most effective personalized therapy still remains a crucial challenge in hematology.

Areas covered: New drugs can specifically target malignant cells and inhibit cancer cell growth, proliferation and survival by specific interactions with one or more target proteins. Recent clinical studies have illustrated promising outcomes for novel drugs used as single agents and in combination with traditional therapeutics. In this article, the authors discuss novel targeted therapies with a promising outcome in NHL patients that are becoming integrated into treatment paradigms.

Expert opinion: The development of new treatment options may help to avoid cytotoxic chemotherapy entirely in some clinical settings. Multicenter studies should be continued to investigate small agents and pathways inhibitors as this will enable us to enhance not only the duration of the treatment response but also the quality of the extended survival.

KEYWORDS:

• Non-Hodgkin lymphoma
• targeted treatment
• monoclonal antibodies
• antibody-drug conjugates
• immune-checkpoint inhibitors
• small molecule inhibitors

Article highlights

• Recent advances have improved the understanding of processes and pathways responsible for NHL-cell proliferation, survival, and resistance.

• A crucial advance was the identification of different components of signaling pathways that are extremely important targets for development of new agents.

• Novel therapeutics directly targeting the pathways involved in cancerogenesis offer hope for future treatments in different types of NHL.

• The majority of novel biologic drugs are selective and have mild or unique toxicity profiles.

• Although impressive responses have been observed in NHL, the integration of novel therapies into drug combinations is the most promising approach.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This work was supported in part by grants from the Medical University of Lodz, Poland (No. 503/8-093-01/503-81-001, No. 502-03/8-093-01/502-64-060, and No. 503/1-1093-01/503-01).