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Anti-CD137 agonists are a class of cancer immunotherapies designed to stimulate the CD137 (4-1BB) receptor, a member of the tumor necrosis factor receptor (TNFR) superfamily. CD137 is primarily expressed on activated T cells and natural killer (NK) cells, where it serves as a potent costimulatory signal. Agonistic binding to CD137 promotes T-cell proliferation, survival, and effector functions, such as the production of interferon-gamma and granzyme B, thereby enhancing the immune system's ability to eliminate tumor cells. While early clinical candidates like urelumab (BMS-663513) and utomilumab (PF-05082566) demonstrated the biological potential of this pathway, their development was hampered by dose-limiting hepatotoxicity or limited monotherapy activity. Current research focuses on next-generation approaches, including bispecific antibodies that target CD137 only in the presence of a tumor-associated antigen (e.g., HER2 or FAP) and combinations with PD-1/PD-L1 inhibitors to overcome immunotherapy resistance.
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