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CD20 is a B-cell marker; rituximab against it was the first antibody approved for cancer, in 1997. This dossier gathers the 13 products (8 approved), 144 trials, 1 pathway and 8 resistance routes in the corpus that involve it, with external identifiers so it can be joined to UniProt, ChEMBL, Open Targets and the rest of biology.
CD20 is a tetraspanin regulating B-cell calcium flux; it is not internalised, favouring effector-based antibodies over ADCs.
| Cancer | Prevalence | Measure | Note | Source |
|---|---|---|---|---|
| Diffuse large B-cell lymphoma | >95% | Surface expression | Wikipedia | |
| Chronic lymphocytic leukaemia | >90% | Dim surface expression | Wikipedia |
Approximate, population-level figures; the measure column says what was counted. Ranges show the midpoint as a bar.
| Modality | Approved | Phase 3 | Phase 2 |
|---|---|---|---|
| T-cell engager 5 | - | ||
| Antibody 4 | - | - | |
| Cell therapy 3 | - | ||
| Bispecific antibody 1 | - | - |
| Trial | Setting | Result | Products | ||
|---|---|---|---|---|---|
EPCORE DLBCL-1 NCT04628494 | 3 | Mixed | R/R DLBCL after ≥1 line, transplant-ineligible: epcoritamab monotherapy vs investigator's choice (R-GemOx or BR) | PFS HR 0.74; OS HR 0.96 (NS). | |
MATRix/IELSG43 NCT02531841 | 3 | Positive | Newly diagnosed primary central nervous system lymphoma in patients up to 70 responding to four cycles of MATRix induction: consolidation with high-dose carmustine and thiotepa and autologous stem cell transplant against two cycles of non-myeloablative rituximab, dexamethasone, etoposide, ifosfamide and carboplatin (R-DeVIC) | Three-year progression-free survival 78 percent after high-dose chemotherapy and autologous transplant against 51 percent after non-myeloablative R-DeVIC (hazard ratio 0.43, p 0.0003), with better overall survival and more toxicity. | |
POLARGO NCT04182204 | 3 | Positive | Relapsed or refractory diffuse large B-cell lymphoma not eligible for an autologous transplant: polatuzumab vedotin added to rituximab, gemcitabine and oxaliplatin | Median overall survival 19.5 against 12.5 months (hazard ratio 0.6, p = 0.0017), with more peripheral neuropathy and more fatal infections. | |
| 3 | Active | A Phase 3, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study to Evaluate the Efficacy and Safety of Tafasitamab Plus Lenalidomide in Addition to Rituximab Versus Lenalidomide in Addition to Rituximab in Patients With Relapsed/Refractory (R/R) Follicular Lymphoma Grade 1 to 3a or R/R Marginal Zone Lymphoma | Median investigator-assessed progression-free survival 22.4 against 13.9 months (hazard ratio 0.43, 95 per cent confidence interval 0.32 to 0.58). | ||
| 3 | Active | A Phase 3, Randomized, Double-blind, Placebo-controlled, Multicenter Study of Bendamustine and Rituximab (BR) Alone Versus in Combination With Acalabrutinib (ACP-196) in Subjects With Previously Untreated Mantle Cell Lymphoma | Median progression-free survival 66.4 against 49.6 months (hazard ratio 0.73, p = 0.0160), with no significant overall survival difference (hazard ratio 0.86, p = 0.27). | ||
| 3 | Active | A Randomized, Double-blind, Placebo-Controlled, Active-Comparator, Multicenter, Phase 3 Study of Brentuximab Vedotin or Placebo in Combination With Lenalidomide and Rituximab in Subjects With Relapsed or Refractory Diffuse Large B-cell Lymphoma (DLBCL) | Median overall survival 13.8 against 8.5 months (hazard ratio 0.63, two-sided p = 0.009) and median progression-free survival 4.2 against 2.6 months (hazard ratio 0.53). | ||
| 3 | Active | A Randomized, Multicenter, Open-Label, Phase 3 Study to Evaluate the Efficacy and Safety of Acalabrutinib Versus Chlorambucil Plus Rituximab in Subjects With Previously Untreated Chronic Lymphocytic Leukemia | - | ||
SUNMO NCT05171647 | 3 | Positive | R/R LBCL, transplant-ineligible: mosunetuzumab + polatuzumab vs R-GemOx | PFS improved (HR reported 2025). | |
AMPLIFY NCT03836261 | 3 | Positive | Fit, previously untreated CLL without del(17p)/TP53: fixed-duration acalabrutinib + venetoclax (AV) or + obinutuzumab (AVO) vs FCR/BR chemoimmunotherapy | 3-year PFS 76.5% (AV) / 83.1% (AVO) vs 66.5%. | |
IELSG37 NCT01599559 | 3 | Positive | Primary mediastinal large B-cell lymphoma in complete metabolic response on PET after rituximab-based immunochemotherapy: consolidation mediastinal radiotherapy versus observation | 30-month progression-free survival 96.7% (observation) vs 98.5% (radiotherapy) in patients with complete metabolic response; radiotherapy can be omitted. | |
STARGLO NCT04408638 | 3 | Mixed | R/R DLBCL, transplant-ineligible, ≥1 prior line: glofitamab + GemOx vs rituximab + GemOx | Overall survival hazard ratio 0.62. A US advisory committee voted 8 to 1 that the trial was not applicable to the US population, and the second-line indication is absent from the US label. | |
TRIANGLE NCT02858258 | 3 | Positive | Previously untreated mantle cell lymphoma in patients up to 65 fit for transplant: alternating R-CHOP and R-DHAP induction followed by autologous transplant (arm A), the same with ibrutinib added to induction and as two-year maintenance (arm A+I), or ibrutinib-containing induction and maintenance without transplant (arm I) | Three-year failure-free survival 88 percent with ibrutinib added to induction, transplant and maintenance against 72 percent with standard induction and transplant (hazard ratio 0.52); transplant was not shown to be superior to an ibrutinib-containing regimen without transplant (72 against 86 percent). | |
| 3 | Active | A Randomized, Multicenter, Open-Label, Phase 3 Study of Acalabrutinib (ACP-196) Versus Investigator's Choice of Either Idelalisib Plus Rituximab or Bendamustine Plus Rituximab in Subjects With R/R Chronic Lymphocytic Leukemia | - | ||
CLL13 / GAIA NCT02950051 | 3 | Positive | Fit, previously untreated CLL without del(17p)/TP53: chemoimmunotherapy (FCR/BR) vs venetoclax-rituximab vs venetoclax-obinutuzumab vs venetoclax-obinutuzumab-ibrutinib | 5-year PFS 81.3% (GIV), 69.8% (GV), 57.4% (RV), 50.7% (CIT). | |
SEQUOIA NCT03336333 | 3 | Positive | Previously untreated CLL/SLL unsuitable for FCR: zanubrutinib vs bendamustine-rituximab (cohort 1); zanubrutinib in del(17p) (arm C); zanubrutinib + venetoclax (arm D) | PFS HR 0.42 vs BR; 5-year PFS 72.2% in del(17p). | |
SHINE NCT01776840 | 3 | Mixed | Aged 65 or over with untreated mantle cell lymphoma: ibrutinib added to six cycles of bendamustine and rituximab, with rituximab maintenance | Median progression-free survival 80.6 against 52.9 months (hazard ratio 0.75, p = 0.01) with no overall survival difference. | |
GLOW NCT03462719 | 3 | Positive | Previously untreated CLL, age ≥65 or with comorbidities, no del(17p)/TP53: fixed-duration ibrutinib + venetoclax vs chlorambucil + obinutuzumab | PFS HR 0.216; OS HR 0.487 (4-year). | |
Inter-B-NHL Ritux 2010 NCT01516580 | 3 | Positive | High-risk mature B-cell non-Hodgkin lymphoma or B-acute leukaemia in patients under 18 (mostly Burkitt lymphoma): LMB chemotherapy with or without six doses of rituximab | 3-year EFS 93.9% vs 82.3%, HR 0.32; OS also improved. | |
Alliance/CALGB 50303 NCT00118209 | 3 | Negative | Untreated diffuse large B-cell lymphoma: six cycles of dose-adjusted EPOCH-R against six cycles of R-CHOP | No difference in progression-free survival (hazard ratio 0.93) or overall survival (1.09) against R-CHOP, with substantially more febrile neutropenia, mucositis and neuropathy. | |
AUGMENT NCT01938001 | 3 | Positive | Relapsed or refractory follicular or marginal zone lymphoma: lenalidomide plus rituximab against rituximab plus placebo | Lenalidomide plus rituximab substantially lengthened progression-free survival compared with rituximab alone; approved in May 2019. | |
CLL14 NCT02242942 | 3 | Positive | Previously untreated CLL with coexisting conditions: 12 months of venetoclax + obinutuzumab vs chlorambucil + obinutuzumab | 6-year PFS 53.1% vs 21.7%; HR 0.40. | |
ELEVATE-TN NCT02475681 | 3 | Positive | Previously untreated CLL, age ≥65 or with comorbidities: acalabrutinib ± obinutuzumab vs chlorambucil + obinutuzumab | 6-year median PFS not reached vs 27.8 months; OS HR 0.62 (A+O). | |
FLYER NCT00278421 | 3 | Positive | Aged 18 to 60 with stage I or II aggressive B-cell lymphoma, normal lactate dehydrogenase, no bulk: four cycles of R-CHOP with six doses of rituximab against six cycles of R-CHOP | Three-year progression-free survival 96 per cent with four cycles of R-CHOP plus two extra rituximab doses, non-inferior to six cycles, with roughly a quarter fewer adverse events. | |
PRIMA NCT00140582 | 3 | Mixed | High tumour burden follicular lymphoma responding to first-line immunochemotherapy: two years of rituximab maintenance against observation | Median progression-free survival 10.5 against 4.1 years (hazard ratio 0.61) with no difference in ten-year overall survival, which was about 80 per cent in both arms. | |
| 3 | Completed | A Randomized, Open Label Study to Assess the Effect of Maintenance Treatment With Mabthera (Rituximab) Versus No Treatment, After Induction Treatment With Rituximab, Cladribine and Cyclophosphamide (RCC) on Progression-Free Survival in Previously Untreated Patients With Progressive B-Cell Chronic Lymphocytic Leukemia | - | ||
MURANO NCT02005471 | 3 | Positive | Relapsed or refractory chronic lymphocytic leukaemia: two years of venetoclax with six cycles of rituximab against six cycles of bendamustine and rituximab | Venetoclax plus rituximab greatly lengthened progression-free survival compared with bendamustine-rituximab, with high rates of undetectable minimal residual disease; approved in June 2018. | |
RELEVANCE NCT01476787 | 3 | Mixed | Previously untreated advanced follicular lymphoma needing treatment: rituximab plus lenalidomide (R2) against rituximab plus the investigator's chemotherapy (R-CHOP, R-CVP or R-bendamustine), both followed by rituximab maintenance, with complete response at 120 weeks and progression-free survival as co-primary endpoints | Complete response at 120 weeks 48 percent with rituximab-lenalidomide against 53 percent with rituximab-chemotherapy (p 0.13) and median progression-free survival 120.2 against 123.8 months (hazard ratio 0.92): not superior, with similar efficacy and a different safety profile. | |
TROG 99.03 NCT00115700 | 3 | Positive | Stage I or II low-grade follicular lymphoma: involved-field radiotherapy alone against radiotherapy followed by six cycles of CVP, with rituximab added from 2006 | Ten-year progression-free survival 59 against 41 per cent when systemic therapy followed radiotherapy (hazard ratio 0.57, p = 0.033), with no significant overall survival difference. | |
GALLIUM NCT01332968 | 3 | Positive | Previously untreated advanced indolent non-Hodgkin lymphoma, mainly follicular lymphoma: obinutuzumab or rituximab with the investigator's chemotherapy (bendamustine, CHOP or CVP), followed by two years of maintenance with the same antibody | Three-year progression-free survival 80.0 percent with obinutuzumab-chemotherapy against 73.3 percent with rituximab-chemotherapy (hazard ratio 0.66, p 0.001); more grade 3 to 5 adverse events with obinutuzumab. | |
GHSG HD18 NCT00515554 | 3 | Positive | Aged 18 to 60 with newly diagnosed advanced-stage Hodgkin lymphoma: treatment intensity set by the scan after two cycles of escalated BEACOPP | Four cycles of escalated BEACOPP non-inferior to six or eight after a negative scan (five-year progression-free survival 92.2 against 90.8 per cent) with half the severe infections; adding rituximab to a positive scan arm did nothing. |
Alternative splicing, mutation, or lineage switch (to myeloid) removes the CD19 epitope.
Transcriptional down-regulation of MS4A1 rather than deletion: CD20 messenger RNA is lower in the negative cells than in the positive cells from the same patient.
Macrophages strip antibody-CD20 complexes off a living cell, lowering surface antigen without any change to the gene.
The antibody kills by borrowing complement, natural killer cells and macrophages; repeated dosing depletes complement locally and leaves the effectors refractory, so retreatment works less well even where the antigen is intact.
Substituting the cysteine the drug binds covalently leaves the kinase active and makes inhibition reversible, so the drug no longer holds.
The CD20 arm fails for the same reasons rituximab does: transcriptional down-regulation and shaving.
Patients who have had several lines of treatment, and especially those who have had CD19 CAR-T, bring a depleted and exhausted T-cell compartment to a drug that is entirely dependent on it.
Suppressive myeloid cells, PD-L1 on the tumour and the stroma, and fibrosis can switch off a synapse the drug has successfully formed.
Complement is a cascade of blood proteins that punches holes in things marked by antibodies and calls in inflammatory cells. Therapeutic antibodies such as rituximab use it to kill cancer cells; tumours defend themselves with shields (CD46, CD55, CD59), and the cascade's own by-products (C5a) can recruit the myeloid cells that protect the tumour.
Which nodes have drugs →No companion diagnostic in the registry measures this target.
No model entry for this target yet; check the cancer entries on the models page.
No open questions recorded for this target yet. Suggest one.
Query for this target: (TITLE:"CD20" OR ABSTRACT:"CD20" OR TITLE:"MS4A1" OR ABSTRACT:"MS4A1") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about CD20, not a curated reading list.
The dossier as machine-readable JSON, at /api/v1/dossiers/cd20.json: identifiers from HGNC, Ensembl, UniProt and ChEMBL, products with status, trials, pathways, hotspots, open questions and assays. The full entity record is in the open API at /api/v1/entities/cd20.json. Licence CC BY-NC 4.0.