Potential mechanisms of anti-CD20 resistance and possible ways to overcome resistance.
| Mechanism of Resistance . | Overcoming Resistance . |
|---|---|
| Abbreviations: ADCC, antibody-mediated cellular cytotoxicity; IFN, interferon; IL, interleukin; G-CSF, granulocyte colony-stimulating factor; CpG, immunostimulatory oligonucleotides | |
| Fc receptor polymorphism | Engineered antibodies to facilitate Fc receptor binding |
| CD20 modulation | IFN-α; CpG; higher dose |
| Pharmacokinetics | Prolonged schedule; higher dose |
| Complement inhibitors | Anti-CD55; Anti-CD59; Bispecific antibodies |
| Decreased ADCC | IL-2; IL-12; IFN-α; G-CSF; CpG |
| Microenvironmental altercations | CpG |
| Impaired CTL generation | Avoid immunosuppressive therapy; CpG; prolonged schedule |
| Tumor-associated resistance | Small molecules; chemotherapy combinations; radioimmunoconjugates |
| Mechanism of Resistance . | Overcoming Resistance . |
|---|---|
| Abbreviations: ADCC, antibody-mediated cellular cytotoxicity; IFN, interferon; IL, interleukin; G-CSF, granulocyte colony-stimulating factor; CpG, immunostimulatory oligonucleotides | |
| Fc receptor polymorphism | Engineered antibodies to facilitate Fc receptor binding |
| CD20 modulation | IFN-α; CpG; higher dose |
| Pharmacokinetics | Prolonged schedule; higher dose |
| Complement inhibitors | Anti-CD55; Anti-CD59; Bispecific antibodies |
| Decreased ADCC | IL-2; IL-12; IFN-α; G-CSF; CpG |
| Microenvironmental altercations | CpG |
| Impaired CTL generation | Avoid immunosuppressive therapy; CpG; prolonged schedule |
| Tumor-associated resistance | Small molecules; chemotherapy combinations; radioimmunoconjugates |