The role of obinutuzumab in the treatment of NHL cancer

Lymphomas are the third neoplasm in the head and neck region, which have varying degrees of malignancy. They originate from the lymphoreticular system and are derived from lymphoid tissue cells, lymphocytes, and histiocytes. We have two types of malignant lymphomas: HL and NHL. The prevalence and mortality of HL is lower than that of NHL, and it is more predictable than NHL.NHL was the eleventh most common cancer and the eleventh leading cause of cancer-related death in ۲۰۲۰. It is classified as a heterogeneous disease and arises from the proliferation of malignant lymphocytes.There are different types of NHL,which include B-cell lymphoma (DLBCL), follicular lymphoma , MCL,and T-cell lymphoma. In these patients, the spread to areas outside the gland is more common , which includes regions such as the thyroid glands, the eye socket, the larynx, the skin, the salivary glands,the paranasal sinuses, and the nasal cavity and Waldeyer's ring. One of the signs observed in ۹۰% of NHL cases is chromosomal translocation, which, along with additional chromosomal deletions and mutations, can lead to the activation of oncogenes or the inactivation of tumor suppressor genes.The NHL pattern is nodular and diffuse.In nodular, tumor cells cluster together to form large aggregates.In the diffuse pattern, however, the cells are uniform and do not cluster, completely destroying the structure of the lymph nodes. Factors that increase the risk of this disease include age, geographical diversity, gender, genetics, immune system disorders, infections,smoking, obesity, certain occupations, pesticides, and organic pollutants. For treatment based on the type and stage of lymphoma, surgery, chemotherapy, immunotherapy, radiation therapy, and stem cell transplantation, as well as antibodies, homogeneous proteins, and other targeted therapies, are used. In this article, we will examine the antibody obinutuzumab. Monoclonal antibodies affect the cellular pathways of the immune system and limit the progression of cancer. Obinutuzumab is a humanized, third-generation, type II monoclonal antibody against CD۲۰, and it is an engineered antibody with a greater affinity for Fc YR receptors. This drug binds to CD۲۰ epitopes on B cells and causes direct cell death through a non-apoptotic pathway, and on rare occasions, it may lead to severe thrombocytopenia.Its side effects in FL include: injection-related reactions, neutropenia, nausea, fatigue, cough, diarrhea, fever, constipation, upper respiratory and urinary tract infections, anemia, and so on. Methods:The research strategy involved searching in databases such as PubMed, Google Scholar, and ScienceDirect. After reviewing and screening,I reached ۳۰ articles in this field. Results:Based on the reviewed articles, obinutuzumab is more effective in the initial treatment of FL when combined with chemotherapy. Also, compared to rituximab, it improves progression-free survival (PFS), especially in patients with FL group, although it has various side effects. Obinutuzumab is a strong inducer of cell-dependent toxicity (antibody-dependent killing), but it weakly induces complement activation and improves the clearance of B cells from human blood and lymphatic tissues in non-human models. Conclusion:Obinutuzumab is an effective treatment option for patients with NHL, but despite its efficacy and manageable side effects, overall survival (OS)cannot be assessed and may be influenced by subsequent treatments.

کلیدواژه ها:

NHL ، Non-Hodgkin Lymphoma ، Obinutuzumab ، DLBCL ، NHL cancer