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HiMTO is a combination chemoimmunotherapy regimen consisting of the anti-CD20 monoclonal antibody zuberitamab, the antimetabolite methotrexate, the alkylating agent thiotepa, and the Bruton's tyrosine kinase (BTK) inhibitor orelabrutinib. It is being investigated as an induction therapy for patients with the MCD subtype of diffuse large B-cell lymphoma (DLBCL), a molecularly defined subgroup characterized by MYD88 and CD79B mutations. The regimen combines the B-cell depleting activity of zuberitamab with the cytotoxic effects of methotrexate and thiotepa, and the targeted inhibition of B-cell receptor signaling by orelabrutinib. This combination is particularly relevant for MCD subtype DLBCL, which often exhibits high rates of central nervous system involvement and reliance on BTK-mediated signaling.
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