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Dulanermin + rituximab is a combination investigational therapy composed of dulanermin—a recombinant form of the human tumor necrosis factor-related apoptosis-inducing ligand (TRAIL; also known as Apo2L)—and rituximab, a monoclonal antibody targeting CD20 on B cells. Dulanermin induces apoptosis in cancer cells by binding to pro-apoptotic death receptors DR4 and DR5 (extrinsic apoptotic pathway), while rituximab promotes cell death via immune-mediated mechanisms. This combination was investigated in patients with relapsed or refractory low-grade (indolent) B-cell non-Hodgkin lymphoma, including follicular lymphoma, based on preclinical synergy between the agents. However, in clinical studies, the addition of dulanermin to rituximab did not improve objective response rate and development was terminated for lymphoma indications[1][2][3][4].
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