Nimotuzumab as a radiosensitizing agent in the treatment of high grade glioma: challenges and opportunities

Arlhee Diaz-Miqueli,^1,* Giselle Saurez Martinez<sup>2,*

1</sup>Department of System Biology, Center of Molecular Immunology, Havana, Cuba; ²Medical Division, Center of Molecular Immunology, Havana, Cuba

*Both authors contributed equally to this manuscript

Abstract: Nimotuzumab is a humanized monoclonal antibody that binds specifically to human epidermal growth factor receptor, blocking receptor activation. Evidence of its radiosensitizing capacity has been widely evaluated. This article integrates published research findings regarding the role of nimotuzumab in the treatment of high grade glioma in combination with radiotherapy or radiochemotherapy in adult and pediatric populations. First, the mechanisms of action of nimotuzumab and its current applications in clinical trials containing both radiation and chemoradiation therapies are reviewed. Second, a comprehensive explanation of potential mechanisms driving radiosensitization by nimotuzumab in experimental settings is given. Finally, future directions of epidermal growth factor receptor targeting with nimotuzumab in combination with radiation containing regimens, based on its favorable toxicity profile, are proposed. It is hoped that this review may provide further insight into the rational design of new approaches employing nimotuzumab as a useful alternative for the therapeutic management of high grade glioma.

Keywords: nimotuzumab, radiation, high grade gliomas