Non^Hodgkin's lymphoma (NHL) is an increasingly common disease that, despite advances in antibody-targeted therapy, still requires novel therapeutic approaches. Tumor necrosis factorr elated apoptosis-inducing ligand (TRAIL) activates a major nonmitochondrial pathway for tumor cell killing through binding to a receptor family, some activating and some decoy. Agonistic antibodies to the receptorsTRAIL-R1and TRAIL-R2 can mimic many of the effects of TRAIL. We are investigating the effects of such agonistic antibodies, mapatumumab directed at TRAIL-R1 and lexatumumab directed atTRAIL-R2, on NHL cell lines.These antibodies induce apoptosis through caspase-8 but also activate BID to involve the mitochondrial pathway and activate caspase-9. In addition, we find signaling through both the nuclear factor-nB and c-Jun NH 2 -terminal kinase pathways. Because the proteasome inhibitor bortezomib also affects these pathways, we have investigated the combination ofTRAIL-R antibodies and bortezomib and show enhanced apoptosis and signaling as well as enhanced killing of NHL cells in a severe combined immunodeficient mouse/human NHL cell line xenograft system. The combination of bortezomib and TRAIL signaling warrants further investigation as a therapeutic regimen. Understanding the multiple intracellular pathways of TRAIL activation may lead to rationally designed therapeutic trials.Non-Hodgkin's lymphoma and need for new therapeutic approaches. The incidence of non -Hodgkin's lymphoma (NHL) is increasing (1). Follicular NHLs are not curable (2) even with high-dose chemotherapy with autologous stem cell support (3, 4). Biological approaches to therapy may lead to improved outcomes. Monoclonal antibodies, such as the chimeric anti-CD20 rituximab, target B cells for killing by several mechanisms. These include direct signaling of apoptosis, activation of complement, and antibody-directed cytotoxicity (5). Rituximab alone (6) or combined with chemotherapy (7) has significant clinical activity in indolent NHL. Novel antibodies targeting other B-cell -specific surface antigens, or binding CD20 but with altered characteristics such as enhanced Fc receptor affinity or humanized sequences, are under clinical investigation. Nonetheless, improved therapy remains an elusive goal.Tumor necrosis factor -related apoptosis-inducing ligand as potential NHL therapy. The major nonmitochondrial pathway of killing involves the CD95/Fas pathway (8), which can be activated by several ligand-receptor interactions, via FADD, ultimately activating caspase-8 and then caspase-3. Tumor necrosis factor -related apoptosis-inducing ligand (TRAIL) promotes apoptosis selectively in cancer cells expressing death receptors with little or no effect on normal cells (9, 10) and can potentiate the effects of radiation and chemotherapy (11 -15).TRAIL induces apoptosis directly via the FADD/caspase-8 -dependent signaling pathway independent of the mitochondrial pathway (16). In addition, in some cells, caspase-8 -dependent cleavage of BID leads to activation...