Monoclonal antibodies (mAbs) are a class of biopharmaceutical drugs made by identical immune cells that are all clones of a unique parent cell. They can be designed to bind to very specific targets on cells, and they have various applications across many therapeutic areas. In oncology, mAbs have emerged as a major class of targeted cancer therapies in recent decades.
Mechanism of Action of Cancer Monoclonal Antibodies
Cancer mAbs work through several mechanisms to fight tumors. Some may block signaling pathways that tumors need to grow and spread. For example, antibodies that target vascular endothelial growth factor (VEGF) can inhibit angiogenesis or new blood vessel formation that feeds tumors. Others may recruit the body's immune system to directly kill tumor cells. Known as immunotherapy, these "naked" mAbs activate immune cells to attack cancer. Still other therapeutic mAbs may carry cytotoxic molecules or radioactive particles directly to tumors. When internalized by cancer cells, these "armed" or "conjugated" antibodies deliver their toxic payload specifically to tumors.
Major Approvals and Clinical Applications
Numerous mAb drugs have now received regulatory approval across many cancer types based on compelling clinical benefits shown in late-stage trials. Some of the earliest approvals included trastuzumab for HER2-positive breast cancer in 1998, rituximab for non-Hodgkin's lymphoma in 1997, and bevacizumab for various solid tumors in 2004. Today, mAbs remain a mainstay of treatment for blood cancers like leukemia and lymphomas. They are also widely used against epithelial cancers of the breast, lung, colon, kidney, and other organs. More recent antibodies like pembrolizumab and nivolumab unleash anti-tumor immunity against cancers regardless of tissue origin through programmed death receptor-1 (PD-1) pathway blockade.
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