New Horizons – The Increasing Use of Monoclonal Antibodies in Oncology Care
Oncology is the branch of medicine concerning the study, diagnosis, treatment and prevention of cancer. Past studies have linked some cancers with certain lifestyle, behavioral and environmental factors. Six main hallmarks of cancerous growth have been described at a cellular level, as presented in Figure 1 .
To some degree cancer can be prevented by avoiding exposure to known risk factors such as tobacco smoke. According to WHO, 70% of lung cancer burden can be attributed to smoking alone. It is estimated based on current trends that as many as 84 million people may die of cancer in the next 10 years. Epidemiological studies show that globally 15 percent of cancers occur via microbial infection .
Micro-organisms such as viruses, bacteria, and parasites can lead to several types of malignancies in humans: Helicobacter pylori, a bacteria, causes gastric cancer due to chronic inflammation; human papillomavirus (HPV) in cervical cancer and herpes virus in Kaposi’s sarcoma . There is no effective cure for cancer yet but targeted therapy with antibodies (antibody therapy) has shown promise in treating the disease.
Monoclonal antibody for Malignancy
Antibody-based therapy has been one of the most important and successful approaches in treating hematological malignancies and solid tumors . Monoclonal antibodies (MAbs) are designed and produced in vitro to precisely target a specified antigen found on cancerous cells. In 1975 Kohler and Milstein were the first to produce MAbs by fusing myeloma cells with murine spleen cells that had been immunized with the desired antigen. However the technology of production of MAbs was not patented and could be used freely in therapeutic and other clinical practices. These antibodies are now used extensively in treatment of cancer, rheumatoid arthritis, Crohn’s disease and various types of infections or allergies. The MAbs directly invade cells through receptor blockade or agonist activity. There effects on target cells include initiation of apoptosis, delivery of a drug, radiation, or cytotoxic agent and immune-mediated cell killing mechanisms.
MAbs in Clinical Trials
• Presently around 50 clinical trials (novel MAb based) being conducted on cancer patients have been registered at www.clinicaltrials.gov.
• The US Food and Drug Administration (FDA) has given approval to 12 MAbs after notable success over the past years to treat numerous types of cancer .
• Over the years the dramatic increase in the number of clinical trials resulted in approval of 30 MAbs for clinical use; many more are currently being tested in clinical trials .
• Current investigations focus on methods to enhance the efficacy of existing MAbs by optimizing their effects and by addition of useful modifications.
• Numerous clinical trials are in progress with MAbs which are entirely derived from human DNA (anti-TNF agent D2E7) .
Therapy in association with cytotoxic drugs or with radionuclides provides new therapeutic methodologies to increase clinical activity of unconjugated MAbs. Hopes rest high for further development of monoclonal antibodies in cancer therapy.
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About the Author: Harsh Vardhan Sharma has a Masters in Biotechnology and is skilled for Medical Writing & Pharmacovigilance jobs. He is also skilled in MedDRA and WHO-DD coding and can be reached at [email protected]
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