CD20 monoclonal antibodies

What are CD20 monoclonal antibodies?

Monoclonal antibodies used in immunotherapy are produced artificially from a cell clone therefore consist of a single type of immunoglobulin. They are targeted towards specific antigens and bind to the antigens to form a complex. The complex can be recognized and destroyed by phagocytes or used for other diagnostic purposes. Natural antibodies are proteins made by the B-lymphocytes in response to antigens. Each B-cell makes only one type of antibody. For therapeutic purposes a significant amount of a particular antibody is needed. These are obtained from a culture that gives a one type of antibody, which are called monoclonal antibodies. CD20 monoclonal antibodies are targeted against B-cell antigens, and were originally developed to treat B-cell Non-Hodgkin’s lymphoma.

Since the inception of rituximab in the 1990s, anti-CD20 monoclonal antibodies have revolutionised the treatment of B cell hematological malignancies and have become a cornerstone of modern gold-standard practice.

Additionally, the potent efficacy of these agents in depleting the B cell compartment has been used in the management of a broad array of autoimmune diseases. Multiple iterations of these agents have been investigated and are routinely used in clinical practice. In this review, we will discuss the physiology of CD20 and its attractiveness as a therapeutic target, as well as the pharmacology, pre-clinical and clinical data for the major anti-CD20 monoclonal antibodies: rituximab, obinutuzumab and ofatumumab.