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Abstract
Clinicians remain believers in B-cell depletion despite the failure of rituximab in the EXPLORER, LUNAR, and BELONG clinical trials.1–3 Additional studies suggested that the B-cell depletion that occurs with rituximab is generally insufficient and that greater B-cell depletion might result in enhanced clinical responses.4 5 This appeared to be the case with obinutuzumab, a Type II anti-CD20 antibody with far greater B-cell killing capacity compared to rituximab. Results of the NOBILITY trial, which evaluated obinutuzumab in lupus nephritis (LN), yielded uplifting results.6 The quest for techniques that could deplete B cells far more robustly than available methods was answered by our oncology colleagues who pioneered chimeric antigen receptor (CAR)-T cell therapy. Although cell therapy has been effective and relatively safe for patients with LN in early studies,7 8 the numbers treated have been small. Thus, there is a huge number of issues surrounding this novel treatment.
References
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Learning Objectives At the end of this presentation participants will be able to:
Explain the effectiveness of rituximab and obinutuzumab in B cell depletion for LN
Discuss the potential benefits and challenges of CAR-T cell therapy for LN
Discuss the need for further research on CAR-T cell therapy in LN
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