Targeted (biological) therapies

Targeted therapies (also called biological therapies) are drugs that use unique features of the cancer to find and destroy cancer cells. The main type used for NHL are called monoclonal antibodies. They target and destroy blood cells called lymphocytes. This reduces the number of abnormal lymphocytes (lymphoma cells) and normal healthy lymphocytes in the body. Once the treatment is over, the level of healthy lymphocytes gradually returns to normal.

The most commonly used targeted therapy used to treat NHL is called rituximab. It can treat several types of B-cell NHL, including diffuse large B-cell lymphoma and follicular lymphoma. You may have rituximab on its own or with chemotherapy.

There are other monoclonal antibodies and other types of targeted treatment you may have. You may have them as part of a clinical trial.

Targeted therapies

Targeted therapies (also called biological therapies) are drugs that use unique features of the cancer to find and destroy cancer cells. These drugs mainly ‘target’ the cancer cells, so they have less effect on healthy cells.

The main type of targeted therapy used to treat NHL is a monoclonal antibody called rituximab. This works by encouraging the body’s immune system to attack and destroy the lymphoma cells.

How targeted therapies work

This animation shows how targeted therapies work and what effect they have on the body.

About our cancer information videos

How targeted therapies work

This animation shows how targeted therapies work and what effect they have on the body.

About our cancer information videos


Monoclonal antibody therapy

Antibodies are part of the body’s natural defence against infection. They recognise harmful cells and destroy them.

Monoclonal antibodies are man-made drugs designed to target certain types of cell. Monoclonal antibody treatments for NHL are designed to target and destroy lymphocytes. The treatment is given as a drip into a vein (intravenous infusion) and can usually be given to you as an outpatient.

The monoclonal antibody most commonly used to treat NHL is rituximab.

Rituximab

Rituximab is used to treat some types of B-cell NHL, including the two most common types: follicular lymphoma and diffuse large B-cell lymphoma. Rituximab may be given on its own or in combination with chemotherapy.

Rituximab attaches to a protein called CD20 on the surface of B-cell lymphocytes. This stimulates the body’s natural defence (the immune system) to attack and destroy the lymphocytes. Because of this, doctors sometimes call it immunotherapy.

Treatment with rituximab reduces the number of healthy B-cells, as well as destroying lymphoma cells. But once the treatment has finished, the level of healthy B-cells in the blood will usually gradually return to normal.

Rituximab can be used in different ways. We have more information about rituximab.

Maintenance treatment

For some types of NHL, rituximab treatment continues after the lymphoma is in remission. The aim is to keep the lymphoma away for as long as possible. It may be given every 2 to 3 months for up to 3 years, or for as long as it is keeping the lymphoma in remission. This is called maintenance treatment.

Other monoclonal antibodies

Several other monoclonal antibodies are also being developed. You may be offered these as part of a research trial.

Possible side effects

Infusion reaction

Sometimes, people have a reaction while being given a monoclonal antibody, or soon after.

The symptoms of a reaction may include:

  • a high temperature (fever)
  • shakes (rigors)
  • a rash
  • low blood pressure
  • feeling sick (nausea).

A reaction is most likely to happen the first time you have the treatment, so you will be given your first infusion slowly to reduce the chance of one occurring. You will also be given medicines to help reduce any reaction that does happen. Reactions are usually milder with a second infusion, and any more after that.

Lowered numbers of blood cells

Monoclonal antibodies can temporarily reduce the number of normal white blood cells in your blood. During this time, you are more likely to get an infection and you may get tired easily. If you have any signs of infection during chemotherapy, it is very important to contact the hospital for advice immediately.


Other targeted therapies

People with some rarer types of NHL may have other types of targeted therapy as part of their treatment.

A targeted therapy drug called bortezomib (Velcade®) is sometimes used as part of the treatment for mantle cell lymphoma. It is given as an injection into a vein or as an injection under the skin (subcutaneously).

Other types of targeted therapy are being developed. They may be used to treat lymphoma as part of a clinical trial.

We have more information about targeted therapy drugs and their side effects.

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