Unraveling the Landscape of Rituximab Resistance in Diffuse Large B-Cell Lymphoma

Xiaoting Liao; Ting Wei; Qingshan Li

doi:10.54097/j6vv6v17

Authors

Xiaoting Liao
Ting Wei
Qingshan Li

DOI:

https://doi.org/10.54097/j6vv6v17

Keywords:

CD20, Diffuse Large B-cell lymphoma, Resistance Mechanisms, Rituximab

Abstract

Rituximab has profoundly improved outcomes for patients with Diffuse large B-cell lymphoma, yet the development of drug resistance continues to pose a serious clinical challenge, leading to treatment failure in 30–40% of cases. Previous studies have revealed several key resistance mechanisms underlying rituximab resistance, such as CD20 antigen expression and conformation, functional impairments in immune effector mechanisms such as antibody-dependent cellular cytotoxicity (ADCC) and complement-dependent cytotoxicity (CDC), the establishment of an immunosuppressive tumor microenvironment (TME), and the activation of intrinsic tumor cell survival pathways. Despite these advances, the resistance landscape of rituximab in diffuse large B-cell lymphoma is not fully mapped; for instance, the roles of ferroptosis and non-coding RNAs remain to be elucidated. This review will summarize these mechanisms to help provide insights that will aid in the development of novel therapeutic strategies and facilitate more personalized approaches to overcome resistance and improve patient outcomes.

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