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Anti-CD137 monoclonal antibodies (mAbs) are a class of agonistic immunotherapies designed to target and activate CD137 (also known as 4-1BB), a member of the tumor necrosis factor receptor (TNFR) superfamily. CD137 is an inducible costimulatory molecule expressed on the surface of activated CD4+ and CD8+ T cells, natural killer (NK) cells, and certain myeloid cells. Binding of these antibodies to CD137 mimics the action of its natural ligand (CD137L), leading to the recruitment of TNFR-associated factors (TRAFs) and the activation of NF-κB, MAPK, and AKT signaling pathways. This results in enhanced T-cell proliferation, increased cytokine secretion (such as IFN-γ and IL-2), and improved survival of effector T cells. In clinical oncology, anti-CD137 mAbs are investigated for their ability to promote a durable anti-tumor immune response, particularly when used in combination with PD-1/PD-L1 inhibitors or chemotherapy. The development of first-generation agonists like urelumab was limited by significant hepatotoxicity, prompting the development of second-generation antibodies with modified binding affinities or localized delivery mechanisms to improve the therapeutic index.
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