Immunotherapy, Biotherapeutics and Advanced Therapies Division, Science, Research, and Innovation Group, Medicines and Healthcare products Regulatory Agency (MHRA), Hertfordshire, UK.
J Cell Mol Med. 2024 Jul;28(13):e18470. doi: 10.1111/jcmm.18470.
Recombinant antibodies (Abs) are an integral modality for the treatment of multiple tumour malignancies. Since the Food and Drug Administration (FDA) approval of rituximab as the first monoclonal antibody (mAb) for cancer treatment, several mAbs and antibody (Ab)-based therapies have been approved for the treatment of solid tumour malignancies and other cancers. These Abs function by either blocking oncogenic pathways or angiogenesis, modulating immune response, or by delivering a conjugated drug. The use of Ab-based therapy in cancer patients who could benefit from the treatment, however, is still limited by associated toxicity profiles which may stem from biological features and processes related to target binding, alongside biochemical and/or biophysical characteristics of the therapeutic Ab. A significant immune-related adverse event (irAE) associated with Ab-based therapies is cytokine release syndrome (CRS), characterized by the development of fever, rash and even marked, life-threatening hypotension, and acute inflammation with secondary to systemic uncontrolled increase in a range of pro-inflammatory cytokines. Here, we review irAEs associated with specific classes of approved, Ab-based novel cancer immunotherapeutics, namely immune checkpoint (IC)-targeting Abs, bispecific Abs (BsAbs) and Ab-drug-conjugates (ADCs), highlighting the significance of harmonization in preclinical assay development for safety assessment of Ab-based biotherapeutics as an approach to support and refine clinical translation.
重组抗体(Abs)是治疗多种肿瘤恶性肿瘤的重要手段。自食品和药物管理局(FDA)批准利妥昔单抗作为第一种用于癌症治疗的单克隆抗体(mAb)以来,已有几种 mAb 和基于抗体的疗法被批准用于治疗实体瘤恶性肿瘤和其他癌症。这些 Abs 通过阻断致癌途径或血管生成、调节免疫反应或传递缀合药物来发挥作用。然而,在可能受益于治疗的癌症患者中,基于 Ab 的治疗的使用仍然受到相关毒性特征的限制,这些特征可能源于与靶标结合相关的生物学特征和过程,以及治疗性 Ab 的生化和/或生物物理特征。与 Ab 为基础的治疗相关的一种显著的免疫相关不良事件(irAE)是细胞因子释放综合征(CRS),其特征是发热、皮疹,甚至明显的、危及生命的低血压和急性炎症,继发于全身不受控制的一系列促炎细胞因子的增加。在这里,我们回顾了与已批准的基于 Ab 的新型癌症免疫疗法的特定类别相关的 irAE,即免疫检查点(IC)靶向 Abs、双特异性 Abs(BsAbs)和 Ab-药物偶联物(ADCs),强调了在临床前检测开发中协调一致的重要性,以评估 Ab 为基础的生物疗法的安全性,作为支持和完善临床转化的方法。
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