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. 2021 Nov 6;148(1):177–190. doi: 10.1007/s00432-021-03833-x

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© The Author(s) 2021

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — Anti-cancer mechanism of action of antibodies directed against CD19 on the surface of malignant B cells (Hartley 2020; Duell et al. 2019; Cheson et al. 2021). Blinatumomab (top left) binds simultaneously to CD19 and to CD3 receptors on T-cells, which brings the effector and malignant cells into close proximity to each other, and facilitates antibody-dependent cellular cytotoxicity (ADCC). Tafasitamab (top right) binds with high affinity to both CD19 and Fc gamma receptors (FcγR) on effector cells. Binding to FcγRIII on natural killer cells facilitates ADCC, while binding to FcγR on macrophages facilitates antibody-dependent cellular phagocytosis (ADCP). Tafasitamab also has direct cytotoxic effects. Loncastuximab tesirine (bottom right) is an anti-CD19 antibody–drug conjugate that contains a cytotoxic pyrrolobenzodiazepine dimer (PBD). Antibody binding to cell surface CD19 leads to internalization of the complex and intracellular release of the PBD payload. The PBD then binds to the minor groove of DNA, and forms inter-strand cross-links that are not recognized by DNA repair mechanisms, thereby leading to cell death