{"entity":{"id":"cd20","kind":"target","name":"CD20","aka":[],"tldr":"CD20 is a B-cell marker; rituximab against it was the first antibody approved for cancer, in 1997.","summary":"CD20 (MS4A1) is a B-cell tetraspanin that regulates calcium flux; it is not internalised, which favours effector-based antibodies and T-cell engagers over ADCs, and it is present on over 95% of DLBCL and, more dimly, over 90% of CLL. It is the target of rituximab, the first antibody approved for cancer in 1997, and of obinutuzumab. The CD20×CD3 bispecifics glofitamab, epcoritamab, mosunetuzumab, and odronextamab now offer off-the-shelf T-cell redirection in lymphoma without the manufacturing wait of CAR-T. Loss of CD20 expression is a recognised escape route after repeated anti-CD20 therapy, and the best sequencing of bispecifics versus CAR-T is still being worked out. The simple version is the B-cell marker that started antibody therapy for cancer and now anchors the newest T-cell engagers.","asOf":"2026-09-04","wikipedia":"https://en.wikipedia.org/wiki/CD20","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/CD20"},{"label":"Hiraga et al., Blood 2009: CD20-negative transformation after rituximab-containing chemotherapy (19 rebiopsied patients)","url":"https://doi.org/10.1182/blood-2008-08-175208"}],"tags":["antibody-target"],"related":["cd20-expression"],"cancers":["dlbcl","cll","non-hodgkin-lymphoma"],"sections":[],"technologies":[],"targets":[],"drugs":["ibritumomab-tiuxetan","ofatumumab","rondecabtagene-autoleucel","tqb2825","zamtocabtagene-autoleucel","azd5492","jnj-90014496"],"companies":["leah-labs","lyell-immunopharma","poseida-therapeutics"],"institutions":[],"pathways":[],"terms":[],"trials":["nct07284433"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":["Lymphoma: Almost every mature B-cell lymphoma: diffuse large B-cell, follicular, marginal zone, mantle cell, Burkitt, and the B cells of nodular lymphocyte-predominant Hodgkin lymphoma. Also on healthy cells: Every normal B cell from the late pre-B stage to the memory B cell. The Human Protein Atlas reads MS4A1 as tissue enriched in lymphoid tissue (631 nTPM) and lineage enriched in B cells (630 nTPM), which is the strongest B-cell signal of any lymphoma surface target. What the medicine does: CD20 is a tetraspanin that is not internalised when an antibody binds it, so the antibody has to kill from the outside: complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity and phagocytosis. That is why CD20 carries naked antibodies (rituximab, obinutuzumab, ofatumumab) and T-cell engagers (glofitamab, mosunetuzumab, epcoritamab, odronextamab) but no antibody-drug conjugate: there is no route in for a payload. How tumours lose it: CD20-negative transformation after rituximab is real and under-measured because most relapses are not rebiopsied. In a single-centre series of 124 patients treated with rituximab-containing chemotherapy, 36 relapsed or progressed, 19 were rebiopsied and 5 of those 19 (26.3%) had become CD20 protein-negative; CD20 messenger RNA was lower in the negative cells than in the positive cells from the same patient, so this is transcriptional down-regulation rather than deletion (Hiraga 2009). Trogocytosis, in which macrophages shave antibody-CD20 complexes off the cell surface, lowers the antigen without changing the gene at all. What that costs the patient: B-cell aplasia for six to twelve months after the last dose, low immunoglobulin levels that can persist for years, and a measurable rise in bacterial and viral infection. Two consequences are specific and avoidable: hepatitis B reactivation, which is why surface antigen and core antibody are checked before the first dose, and a blunted response to vaccination for several months after treatment."],"symbol":"MS4A1","role":[],"sources":[],"specificity":"lineage-antigen","distribution":"few-types","specificityNote":"Lineage antigen shared with normal B-cells and lymphoid tissue cells: the label readouts filed under it score its expression (CD20 expression (CD20-positive)), and HPA finds the gene lineage enriched in that blood lineage at or above 25 nTPM, so medicines aimed at it clear the normal lineage too. HPA MS4A1: RNA tissue enriched (lymphoid tissue 631 nTPM); blood lineage lineage enriched (B-cells 630 nTPM); high antibody staining in 4 normal tissues; highest cancer staining lymphoma (11 of 12 high). Distribution: 2 cancer families in the corpus carry a prevalence row, label threshold or catalogue link for it (Lymphoma, Leukaemia); Open Targets associates it with 6 specific cancer types at or above 0.5 (B-cell chronic lymphocytic leukemia, diffuse large B-cell lymphoma, follicular lymphoma, non-Hodgkin lymphoma, acute lymphoblastic leukemia, B-cell non-Hodgkin lymphoma). (Rule 3 of scripts/fetch-target-specificity.ts.)","specificitySources":[{"label":"CD20 expression (CD20-positive) label threshold","url":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b172773b-3905-4a1c-ad95-bab4b6126563","note":"CD20-positive"},{"label":"Human Protein Atlas MS4A1 tissue","url":"https://www.proteinatlas.org/ENSG00000156738-MS4A1/tissue","note":"RNA tissue and blood lineage specificity, normal tissue antibody staining (version 25.1, CC BY-SA 3.0)"},{"label":"Human Protein Atlas MS4A1 pathology","url":"https://www.proteinatlas.org/ENSG00000156738-MS4A1/pathology","note":"patients per staining level per cancer type (version 25.1, CC BY-SA 3.0)"},{"label":"Open Targets ENSG00000156738 associations","url":"https://platform.opentargets.org/target/ENSG00000156738/associations","note":"cancer associations at or above 0.5 (CC0)"}],"hgnc":"HGNC:7315","ensembl":"ENSG00000156738","uniprot":"P11836","entrez":"931","firstDescribed":1988,"firstDescribedBasis":"sequence","firstDescribedNote":"Earliest sequence paper UniProt cites for the protein: Stamenkovic et al, J. Exp. Med, 1988, \"Analysis of two cDNA clones encoding the B lymphocyte antigen CD20 (B1, Bp35), a type III integral membrane protein\".","firstDescribedSource":"https://pubmed.ncbi.nlm.nih.gov/3260267/","biology":"CD20 is a tetraspanin regulating B-cell calcium flux; it is not internalised, favouring effector-based antibodies over ADCs.","whereFound":["DLBCL","Follicular lymphoma","CLL","Mantle cell lymphoma"],"targetClass":"surface-antigen","prevalence":[{"cancerId":"dlbcl","pct":">95","measure":"Surface expression","source":"https://en.wikipedia.org/wiki/CD20"},{"cancerId":"cll","pct":">90","measure":"Dim surface expression","source":"https://en.wikipedia.org/wiki/CD20"}]},"route":"/targets/cd20/","neighbours":{"biomarker":[{"id":"cd20-expression","kind":"biomarker","name":"CD20 expression (CD20-positive)","route":"/biomarkers/cd20-expression/"}],"cancer":[{"id":"burkitt-lymphoma","kind":"cancer","name":"Burkitt lymphoma","route":"/cancers/burkitt-lymphoma/"},{"id":"cll","kind":"cancer","name":"Chronic lymphocytic leukaemia","route":"/cancers/cll/"},{"id":"cll-treatment-naive","kind":"cancer","name":"Chronic lymphocytic leukaemia, first treatment","route":"/cancers/cll-treatment-naive/"},{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"malt-lymphoma","kind":"cancer","name":"Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma)","route":"/cancers/malt-lymphoma/"},{"id":"follicular-lymphoma","kind":"cancer","name":"Follicular lymphoma","route":"/cancers/follicular-lymphoma/"},{"id":"hairy-cell-leukemia","kind":"cancer","name":"Hairy cell leukaemia","route":"/cancers/hairy-cell-leukemia/"},{"id":"hiv-associated-lymphoma","kind":"cancer","name":"HIV-associated (AIDS-related) lymphomas","route":"/cancers/hiv-associated-lymphoma/"},{"id":"mantle-cell-lymphoma","kind":"cancer","name":"Mantle cell lymphoma","route":"/cancers/mantle-cell-lymphoma/"},{"id":"marginal-zone-lymphoma","kind":"cancer","name":"Marginal zone lymphoma","route":"/cancers/marginal-zone-lymphoma/"},{"id":"mediastinal-grey-zone-lymphoma","kind":"cancer","name":"Mediastinal grey zone lymphoma","route":"/cancers/mediastinal-grey-zone-lymphoma/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"},{"id":"post-transplant-lymphoproliferative-disorder","kind":"cancer","name":"Post-transplant lymphoproliferative disorder (PTLD)","route":"/cancers/post-transplant-lymphoproliferative-disorder/"},{"id":"primary-cns-lymphoma","kind":"cancer","name":"Primary CNS lymphoma","route":"/cancers/primary-cns-lymphoma/"},{"id":"primary-mediastinal-b-cell-lymphoma","kind":"cancer","name":"Primary mediastinal (thymic) large B-cell lymphoma","route":"/cancers/primary-mediastinal-b-cell-lymphoma/"},{"id":"cll-relapsed","kind":"cancer","name":"Relapsed or refractory chronic lymphocytic leukaemia","route":"/cancers/cll-relapsed/"},{"id":"richter-transformation-cll","kind":"cancer","name":"Richter transformation of chronic lymphocytic leukaemia","route":"/cancers/richter-transformation-cll/"},{"id":"t-cell-histiocyte-rich-large-b-cell-lymphoma","kind":"cancer","name":"T-cell/histiocyte-rich large B-cell lymphoma","route":"/cancers/t-cell-histiocyte-rich-large-b-cell-lymphoma/"},{"id":"waldenstrom","kind":"cancer","name":"Waldenström macroglobulinaemia","route":"/cancers/waldenstrom/"}],"drug":[{"id":"azd5492","kind":"drug","name":"AZD5492","route":"/drugs/azd5492/"},{"id":"epcoritamab","kind":"drug","name":"Epcoritamab","route":"/drugs/epcoritamab/"},{"id":"glofitamab","kind":"drug","name":"Glofitamab","route":"/drugs/glofitamab/"},{"id":"ibritumomab-tiuxetan","kind":"drug","name":"Ibritumomab tiuxetan","route":"/drugs/ibritumomab-tiuxetan/"},{"id":"jnj-90014496","kind":"drug","name":"JNJ-90014496","route":"/drugs/jnj-90014496/"},{"id":"mosunetuzumab","kind":"drug","name":"Mosunetuzumab","route":"/drugs/mosunetuzumab/"},{"id":"obinutuzumab","kind":"drug","name":"Obinutuzumab","route":"/drugs/obinutuzumab/"},{"id":"odronextamab","kind":"drug","name":"Odronextamab","route":"/drugs/odronextamab/"},{"id":"ofatumumab","kind":"drug","name":"Ofatumumab","route":"/drugs/ofatumumab/"},{"id":"rituximab","kind":"drug","name":"Rituximab","route":"/drugs/rituximab/"},{"id":"rondecabtagene-autoleucel","kind":"drug","name":"Rondecabtagene autoleucel","route":"/drugs/rondecabtagene-autoleucel/"},{"id":"tqb2825","kind":"drug","name":"TQB2825","route":"/drugs/tqb2825/"},{"id":"zamtocabtagene-autoleucel","kind":"drug","name":"Zamtocabtagene autoleucel","route":"/drugs/zamtocabtagene-autoleucel/"}],"company":[{"id":"cellogen","kind":"company","name":"Cellogen Therapeutics","route":"/companies/cellogen/"},{"id":"dr-reddys","kind":"company","name":"Dr. Reddy's Laboratories","route":"/companies/dr-reddys/"},{"id":"hetero","kind":"company","name":"Hetero Drugs","route":"/companies/hetero/"},{"id":"interius","kind":"company","name":"Interius BioTherapeutics","route":"/companies/interius/"},{"id":"leah-labs","kind":"company","name":"LEAH Labs","route":"/companies/leah-labs/"},{"id":"lyell-immunopharma","kind":"company","name":"Lyell Immunopharma","route":"/companies/lyell-immunopharma/"},{"id":"poseida-therapeutics","kind":"company","name":"Poseida Therapeutics","route":"/companies/poseida-therapeutics/"},{"id":"tg-therapeutics","kind":"company","name":"TG Therapeutics","route":"/companies/tg-therapeutics/"}],"trial":[{"id":"nct04680052","kind":"trial","name":"A Phase 3 Study to Assess Efficacy and Safety of Tafasitamab Plus Lenalidomide and Rituximab Compared to Placebo Plus Lenalidomide and Rituximab in Pa","route":"/trials/nct04680052/"},{"id":"nct02972840","kind":"trial","name":"A Study of BR Alone Versus in Combination With Acalabrutinib in Subjects With Previously Untreated MCL","route":"/trials/nct02972840/"},{"id":"nct03888105","kind":"trial","name":"A Study to Assess the Anti-Tumor Activity and Safety of Odronextamab in Adult Patients With B-cell Non-Hodgkin Lymphoma Who Have Been Previously Treat","route":"/trials/nct03888105/"},{"id":"amplify","kind":"trial","name":"AMPLIFY","route":"/trials/amplify/"},{"id":"arched","kind":"trial","name":"ARCHED","route":"/trials/arched/"},{"id":"nct04404283","kind":"trial","name":"Brentuximab Vedotin Plus Lenalidomide and Rituximab for the Treatment of Relapsed/Refractory DLBCL","route":"/trials/nct04404283/"},{"id":"cll13-gaia","kind":"trial","name":"CLL13 / GAIA","route":"/trials/cll13-gaia/"},{"id":"cll14","kind":"trial","name":"CLL14","route":"/trials/cll14/"},{"id":"elevate-tn","kind":"trial","name":"ELEVATE-TN","route":"/trials/elevate-tn/"},{"id":"enrich","kind":"trial","name":"ENRICH","route":"/trials/enrich/"},{"id":"fortplus","kind":"trial","name":"FORTplus","route":"/trials/fortplus/"},{"id":"goya","kind":"trial","name":"GOYA","route":"/trials/goya/"},{"id":"ielsg-19","kind":"trial","name":"IELSG-19","route":"/trials/ielsg-19/"},{"id":"inter-b-nhl-ritux-2010","kind":"trial","name":"Inter-B-NHL Ritux 2010","route":"/trials/inter-b-nhl-ritux-2010/"},{"id":"lyma","kind":"trial","name":"LyMa","route":"/trials/lyma/"},{"id":"mosun-lbt-fl","kind":"trial","name":"Mosunetuzumab against rituximab in low tumour burden follicular lymphoma","route":"/trials/mosun-lbt-fl/"},{"id":"mosun-len-mzl","kind":"trial","name":"Mosunetuzumab with lenalidomide in relapsed marginal zone lymphoma","route":"/trials/mosun-len-mzl/"},{"id":"polar-bear","kind":"trial","name":"POLAR BEAR","route":"/trials/polar-bear/"},{"id":"polargo","kind":"trial","name":"POLARGO","route":"/trials/polargo/"},{"id":"prima-follicular","kind":"trial","name":"PRIMA","route":"/trials/prima-follicular/"},{"id":"prima-cns","kind":"trial","name":"PRIMA-CNS","route":"/trials/prima-cns/"},{"id":"rosewood","kind":"trial","name":"ROSEWOOD","route":"/trials/rosewood/"},{"id":"shine","kind":"trial","name":"SHINE","route":"/trials/shine/"},{"id":"nct07284433","kind":"trial","name":"Study of Allo-QuadCAR01-T, an Allogeneic CAR-T Targeting CD19/CD20, in Patients With Relapsed or Refractory B-Cell Malignancies","route":"/trials/nct07284433/"}],"pairing":[{"id":"venetoclax-plus-obinutuzumab","kind":"pairing","name":"Venetoclax + obinutuzumab (12 months)","route":"/pairings/venetoclax-plus-obinutuzumab/"}],"term":[{"id":"lymphoma-bio-antigen-escape","kind":"term","name":"Antigen escape: how a lymphoma loses the thing the drug was aimed at","route":"/terms/lymphoma-bio-antigen-escape/"},{"id":"b-cell","kind":"term","name":"B cell","route":"/terms/b-cell/"},{"id":"lymphoma-b-versus-t-cell","kind":"term","name":"B-cell, T-cell and NK-cell lymphoma","route":"/terms/lymphoma-b-versus-t-cell/"},{"id":"lymphoma-type","kind":"term","name":"Lymphoma (tissue type)","route":"/terms/lymphoma-type/"},{"id":"lymphoma-bio-lineage-antigen-cost","kind":"term","name":"What it costs to aim at a lineage antigen","route":"/terms/lymphoma-bio-lineage-antigen-cost/"}],"paper":[{"id":"paper-echo-acalabrutinib-bendamustine-rituximab-mantle-cell-jco-2025","kind":"paper","name":"Acalabrutinib plus bendamustine-rituximab in untreated mantle cell lymphoma","route":"/key-papers/paper-echo-acalabrutinib-bendamustine-rituximab-mantle-cell-jco-2025/"},{"id":"paper-amplify-acalabrutinib-venetoclax-nejm-2025","kind":"paper","name":"AMPLIFY: fixed-duration acalabrutinib plus venetoclax, with or without obinutuzumab, versus 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genetics-directed trials now recruiting","route":"/roadmaps/lymphoma-roadmap/"}],"idea":[{"id":"idea-fund-abbreviated-pathway-me-too-biologics","kind":"idea","name":"An abbreviated approval path for follow-on antibodies within a validated class","route":"/ideas/idea-fund-abbreviated-pathway-me-too-biologics/"},{"id":"lymphoma-ev-fixed-duration-chemotherapy-free-first-line","kind":"idea","name":"Fixed-duration, chemotherapy-free first-line treatment for the indolent lymphomas","route":"/ideas/lymphoma-ev-fixed-duration-chemotherapy-free-first-line/"},{"id":"idea-bio1-adaptive-car-antigen-switch","kind":"idea","name":"Plan the second CAR-T target before the first one is lost","route":"/ideas/idea-bio1-adaptive-car-antigen-switch/"}],"technology":[{"id":"bispecific-antibody","kind":"technology","name":"Bispecific antibodies","route":"/technologies/bispecific-antibody/"},{"id":"t-cell-engager","kind":"technology","name":"T-cell engagers (bispecific)","route":"/technologies/t-cell-engager/"}],"person":[{"id":"barbara-eichhorst","kind":"person","name":"Barbara Eichhorst","route":"/people/barbara-eichhorst/"},{"id":"catherine-thieblemont","kind":"person","name":"Catherine Thieblemont","route":"/people/catherine-thieblemont/"},{"id":"christopher-flowers","kind":"person","name":"Christopher R. 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Wilson","route":"/people/wyndham-wilson/"}],"institution":[{"id":"sant-orsola-bologna","kind":"institution","name":"IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola","route":"/institutions/sant-orsola-bologna/"},{"id":"southampton-cancer","kind":"institution","name":"University Hospital Southampton / Centre for Cancer Immunology","route":"/institutions/southampton-cancer/"}],"pathway":[{"id":"complement-in-cancer","kind":"pathway","name":"Complement in cancer","route":"/pathways/complement-in-cancer/"},{"id":"nk-cell-recognition","kind":"pathway","name":"NK-cell recognition: missing self & stress ligands","route":"/pathways/nk-cell-recognition/"}]}}