Relapsed/refractory diffuse large B-cell lymphoma and other non-Hodgkin lymphomas represent significant clinical challenges, particularly in patients who have exhausted standard immunochemotherapy and cellular therapies. Bispecific antibodies and antibody–drug conjugates have emerged as promising treatments, offering targeted and more effective treatment options compared to current standards. Bispecific antibodies, including epcoritamab and glofitamab, third-line therapies for diffuse large B-cell lymphoma, are recombinant immunoglobulins engineered to recognize two distinct antigens or epitopes simultaneously. This capability enhances therapeutic precision by bridging immune effector cells and tumor cells and modulating multiple signaling pathways involved in the pathogenesis of non-Hodgkin lymphoma. In the context of new therapies, antibody–drug conjugates, such as loncastuximab tesirine, are therapies composed of monoclonal antibodies linked to cytotoxic agents, in which the antibody selectively binds to tumor-associated antigens, delivering the cytotoxic payload directly to cancer cells while minimizing off-target effects. They combine the specificity of antibodies with the potency of chemotherapy, offering enhanced efficacy and safety in hematological malignancies. Ongoing clinical trials are investigating other molecules like odronextamab and the use of bispecific antibodies in combination regimens and earlier lines of therapy. The aim of this review is to explore actual therapies in relapsed/refractory diffuse large B-cell lymphoma, focusing on bispecific antibodies and antibody–drug conjugates.
复发/难治性弥漫性大B细胞淋巴瘤及其他非霍奇金淋巴瘤是临床治疗中的重大挑战，尤其对于已用尽标准免疫化疗及细胞疗法的患者群体。双特异性抗体与抗体偶联药物作为新兴治疗策略，相较于现有标准方案展现出靶向性更强、疗效更优的治疗前景。以艾可瑞妥单抗和格罗菲妥单抗为代表的第三代弥漫性大B细胞淋巴瘤治疗用双特异性抗体，是通过基因工程构建的重组免疫球蛋白，可同时识别两种不同抗原或表位。该特性通过桥接免疫效应细胞与肿瘤细胞，并调控非霍奇金淋巴瘤发病机制中的多条信号通路，从而提升治疗精准度。在新疗法体系中，以洛那妥珠单抗为代表的抗体偶联药物由单克隆抗体与细胞毒性药物偶联而成，其抗体组分可选择性结合肿瘤相关抗原，将细胞毒性载荷精准递送至癌细胞，最大程度减少脱靶效应。这类药物兼具抗体的靶向特异性和化疗药物的强效杀伤力，为血液系统恶性肿瘤提供了疗效与安全性更优的治疗选择。当前多项临床试验正在探索奥妥珠单抗等其他分子药物，以及双特异性抗体在联合治疗方案和早期治疗线序中的应用。本综述旨在系统探讨复发/难治性弥漫性大B细胞淋巴瘤的现有治疗策略，重点关注双特异性抗体与抗体偶联药物的最新进展。
肿瘤(癌症)患者之家