What are the monoclonal antibodies (and examples)

The monoclonal antibodies are proteins produced in the laboratory, such as trastuzumab, rituximab or adalimumab, which act in the body to bind to specific parts of the virus, bacteria or certain types of cancer cells, helping the immune system to recognize these foreign cells and fight some diseases faster.

Depending on the monoclonal antibody used, these drugs may be indicated for the treatment of serious diseases such as osteoporosis, leukemia, psoriasis in plaques or in some types of cancer, such as breast or breast cancer, and even in the case of COVID-19 infection, for example.

The monoclonal antibodies are medicines used only in hospitals, in an injectable presentation applied by a health professional, directly in the vein under the indication and medical orientation.

Examples of monoclonal antibodies

The main types of monoclonal antibodies include:

1. Recombinant monoclonal antibodies

Recombinant monoclonal antibodies are the most common types of monoclonal antibodies used. These were developed by genetic engineering and specifically attack a protein that is present in foreign cells, stimulating the action of the immune system or blocking specific proteins in tumor cells that cause the tumor to grow or spread, forming metastasis, for example .

Some examples of recombinant monoclonal antibodies are:

• Trastuzumab (Herceptin): indicated for the treatment of breast or stomach cancer, which has the HER2-positive protein and can be used alone or in combination with chemotherapy, depending on the stage of the tumor, according to the medical indication.
• Rituximab (MabThera): indicated for the treatment of CD20 positive non-Hodgkin’s lymphoma, rheumatoid arthritis or chronic lymphoid leukemia, for example;
• Denosumab (Prolia or Xgeva): indicated for the treatment of osteoporosis in women in postmenopause or in men with prostate cancer who have an increased risk of bone fractures, breast cancer or cancer in advanced stages with bone metastasis;
• Adalimumab (Humira): indicated for the treatment of rheumatoid arthritis, ankylosing spondylitis, Crohn’s disease, ulcerative colitis or psoriasis, for example, it blocks a specific protein, TNF-α, which is present at high levels in inflammatory diseases;
• Regdanvimab: indicated for the treatment of the illness caused by COVID-19 in adults who do not need oxygen and are at high risk of developing the severe form of the illness, which works by joining the protein sipke on the surface of the coronavirus, preventing the virus enter in the cells of the body.

These medicines must always be used under the indication and for the treatment period established by the doctor, according to each indication, with individual doses.

2. Conjugated monoclonal antibodies

The conjugated monoclonal antibodies act by transporting substances such as chemotherapeutics or radiotherapeutics, which are released by specific cells in the body, producing their destruction.

The main conjugated monoclonal antibodies are:

• Trastuzumab emtansine: indicated for the treatment of HER-2 positive breast cancer with metastasis, as it works by binding to the HER-2 protein on the surface of tumor cells and releasing the DM1 chemotherapeutic into these cells.
• Brentuximab vedotin: systemic anaplastic large cell lymphoma is indicated for the treatment of CD30 positive Hodkin lymphoma, which acts by releasing the chemotherapeutic within the tumor cells that has the CD30 protein on its surface.

In addition, another conjugated monoclonal antibody, approved in Europe for the treatment of CD20+ B-cell follicular Hodgkin’s lymphoma, is Ibritumomab tiuxetan, which acts by releasing radiotherapy into the tumor cells of this type of tumor, leading to their destruction.

3. Bispecific monoclonal antibodies

Bispecific monoclonal antibodies pose different antibodies, such as blinatumomab, which activates the immune system to attack and destroy tumor white blood cells, and is indicated for the treatment of acute lymphoblastic leukemia.

what are they for

The monoclonal antibodies are indicated for the treatment of illnesses such as:

• Cancer;
• Rheumatoid arthritis;
• Multiple Sclerosis;
• Systemic lupus erythematosus;
• Chron’s illness;
• Ulcerative colitis;
• Psoriasis;
• Ankylosing spondylitis;
• Osteoporosis;
• Transplant rejection.

Treatment with monoclonal antibodies is also called immunotherapy or targeted therapy, because each type of monoclonal antibody targets specific parts of the cells of certain diseases or microorganisms such as viruses or bacteria.

Monoclonal antibodies and COVID-19

Some monoclonal antibodies, such as casirivimab, imdevimab or regdanvimab, act by binding to specific proteins present on the surface of the coronavirus, preventing its ability to infect the cells of the body or helping the immune system to fight it.

These types of monoclonal antibodies are approved in mild to moderate cases or in people who are at risk of evolving into the severe form of COVID-19, for example. See all the medicines used to treat COVID-19.

How to use

The monoclonal antibodies must be used only in hospitals, in the form of injection, applied directly in the vein by a health professional and with medical indication, since the type of body and the recommended doses depend on the illness to be treated and on your serious

In most cases, the monoclonal antibodies are used in the treatment of cancer and can be used alone or in combination with chemotherapy according to the doctor’s instructions.

side effects

The most common side effects that monoclonal antibodies can cause diarrhea or stress, nausea, vomiting, insomnia, abdominal pain or discomfort, excessive tiredness, muscle or joint pain, for example.

In addition, monoclonal antibodies can cause severe allergy or anaphylactic reaction with symptoms that can start immediately after application, such as difficulty breathing, chills, fever, coughs, tight throat, sore throat, tongue or face, or hives . Therefore, the monoclonal antibodies must be applied in hospitals so that the first aid can be provided immediately.

Contraindications

Monoclonal antibodies are contraindicated in children, embarassed women or those who are lactating, in addition to people who have an allergy to the components present in the composition of the drug.