Antibody based cancer therapy has achieved a considerable success in past 15 years. An antibody alternatively known as immunoglobulin is a large Y-shape protein produced by plasma cells that is used by the immune system to identify and neutralize foreign particles such as viruses and bacteria. Therapeutic antibodies have become a significant strategy in clinical oncology owing to their ability to bind with primary and metastatic cancer cells with significant affinity. This leads to the development of anti-cancer/tumor effect out of various means such as direct action of the antibody by immune-mediated cell killing mechanisms, receptor blockage or agonist activities, antibody-dependent cellular cytotoxicity and developing specific effects of an antibody on tumor vasculature and stroma among others. Monoclonal antibodies hold a variety of applications in management of cancer including diagnosis, monitoring as well as treatment of diseases. These monoclonal antibodies are now a days is used by many oncologists to even monitor the disease progression such as estimation and measurement of carcinoembryonic antigen in colon cancer.
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Monoclonal antibodies based on their mechanism of action can be classified into 3 prominent categories such as one which triggers the immune system, blocks tumor cell division signals and at last one which act as a carrier of cancer drugs. Since cancer cells are abnormal in nature and are usually difficult to detect. For triggering an immune system monoclonal antibodies attach themselves to cancerous cells making it easier for the immune systems to track and identify. Prominent antibodies of this type include Rituximab for non-Hodgkin lymphoma (NHL), Alemtuzumab for chronic lymphocytic leukaemia (CLL). There are few monoclonal antibodies that attach themselves to immune cells which can enhance their cell division process so as to produce substantial immune cells to counterattack antibodies depending upon the kind of disease and its stage. For blocking signals with respect to cancerous/tumor cell’s division, some monoclonal antibodies inhibits growth factor receptors responsible for their cell proliferation process. Such kind of monoclonal antibodies include Trastuzumab (Herceptin) for breast and stomach cancer, Panitumumab (Vectibix) for advanced bowel cancer, Bevacizumab (Avastin) for advanced bowel cancer, breast cancer and some other cancers. In another type of monoclonal antibodies which possesses drugs or radiation attached to them. Now, the monoclonal antibodies search, track and delivers drugs and radiation directly to them.
Some of the FDA approved monoclonal antibodies in oncology encompasses Trastuzumab for ERBB2-positive breast cancer, Bevacizumab for first-line and second-line treatment of metastatic colon cancer, Alemtuzumab against B cell chronic lymphocytic leukemia, Brentuximab vedotin for curing refractory Hodgkin’s lymphoma and systemic anaplastic lymphoma among others. During 2010 and 2011, the therapeutic antibody market was primarily concentrated only towards two prominent categories namely oncology and immunology. In 2010, oncology indications made up just over 50% of sales, while the immunological area accounted for almost 40%. Similar trend is likely to continue for next few years as well since majority of the monoclonal based antibodies are yet in phase 2 and phase 3 clinical trial phases.