Monoclonal antibodies and their role in chemotherapy


Many tumor cells express substances on the surface that are unique to tumor cells. These substances might be absent or found in small quantities in normal cells, making tumor cells antigenically not the same as normal cells. These substances are classified as tumor-associated antigens. Monoclonal antibodies are glycoproteins designed to target these tumor-associated antigens. They're produced to identify and bind to antigens expressed by a specific tumor and elicit an immune response.

Antibodies are immunoglobulins made by plasma B cells in reaction to antigens. They're split into five sub-classes, depending on the heavy polypeptide chain they contain. Each class performs a job in the immune response. Monoclonal antibodies are often of the IgG or IgM subclass.

Monoclonal antibodies may be used alone or in in conjunction with cytotoxic agents, toxins, radioisotopes, or biologic agents. Unconjugated mAbs show antitumor activity in many studies. The FDA has approvedtwo unconjugated mAbs for that treatment of cancer. Rituximab was approved in 1997 for that treatment of non-Hodgkin's lymphoma. It's administered like a weekly intravenous infusion in a dose of 375 mg/m 2 for 4 consecutive weeks.

The most typical negative effects occurred throughout the first infusion. Such as fever, chills, rigors, myalgia/arthralgia, urticaria, nausea, diarrhea, and mucosal congestion. Trastuzumab was approved in 1998 like a single agent for that treatment of patients with advanced breast cancer whose tumors overexpress the HER2 proteins and who've received one or more chemotherapy treatments, or in in conjunction with paclitaxel when you have not received chemotherapy.

The first loading dose is run in a dose of 4 mg/kg on the 90-minute intravenous infusion. The constant maintenance dose is 2 mg/kg over Half an hour. The most typical negative effects include chills, fever, nausea, vomiting, pain, rigors, headache, dizziness, dyspnea, hypotension, rash, and asthenia.

Researchers are developing potentially more effective therapy by conjugating mAbs to cytotoxic agents, toxins, or radioisotopes. Monoclonal antibodies conjugated to cytotoxic agents include doxorubicin, daunorubicin, and methotrexate. In theory, chemoimmuno-conjugates target cancer cells and bypass normal cells; therefore, maximum doses of cytotoxic agents could be administered and chemotherapy-related negative effects could be minimized.

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