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Anti-4-1BB antibodies (also known as anti-CD137 antibodies) are a class of agonistic monoclonal antibodies designed to stimulate the 4-1BB receptor, a member of the tumor necrosis factor receptor (TNFR) superfamily. 4-1BB is primarily expressed on activated T cells and natural killer (NK) cells, where it functions as a potent costimulatory molecule. Upon binding, these antibodies trigger signaling pathways that enhance T-cell proliferation, survival, and effector functions, such as cytokine production and cytolytic activity. This mechanism is intended to augment the anti-tumor immune response. Clinical development has seen two primary generations: first-generation agonists like urelumab (IgG4) and utomilumab (IgG2), which faced challenges regarding liver toxicity and efficacy, and next-generation molecules including bispecific antibodies (e.g., 4-1BB x PD-L1) and localized agonists designed to improve the therapeutic window.
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