Current status and perspective of antibody therapy in follicular lymphoma

The development of antibody--based therapeutic strategies has clearly changed the standard clinical approach to patients with advanced stage follicular lymphoma. The chimeric monoclonal anti-CD20 antibody rituximab has shown high efficacy in previously untreated and relapsed or refractory patients. Rituximab combined with conventional chemotherapy is a highly attractive approach with proven synergism in vitro and in vivo and is widely accepted as standard treatment for advanced stage follicular lymphoma. Furthermore, rituximab maintenance has been shown to improve disease control after successful cytoreduction with rituximab as a single agent therapy or polychemotherapy. Additional antibodies, different target molecules and modified schedules are currently being evaluated in preclinical and clinical trials. Strategies to enhance the efficacy of antibody--based therapies include stimulation of innate immunity and the generation of immunotoxins and radioimmunoconjugates (radioimmunotherapy). Ongoing studies are evaluating the role of monoclonal antibodies in multimodal therapeutic approaches to further improve response rates and duration with the final aim of prolonging overall survival of patients with advanced stage follicular lymphoma.