Abstract: Monoclonal antibodies have high physicochemical properties, single biological activity, strong specificity for antigen binding, easy man-made processing and quality control, and easy source, so they are welcomed and valued. In the medical field, monoclonal antibodies play a huge role in the diagnosis of diseases, prognosis, disease prevention and disease mechanisms. The advent of monoclonal antibody drugs has revolutionized the way diseases are treated. In the past 20 years, monoclonal antibody drugs have played an important role in the treatment of diseases such as cancer and autoimmunity. The low toxicity and high specificity of monoclonal antibody drugs is the key to their success. These two advantages of monoclonal antibody drugs make them a quick substitute for traditional chemotherapy, but their therapeutic effects are also plagued by drug resistance. Drug resistance is one of the reasons for the inhibition of the therapeutic effect of monoclonal antibody drugs. The monoclonal antibody drug is targeted to bind to tumor cells and then cleared, which is called antibody modulation. This article will focus on the clinical application of monoclonal antibodies.
Keywords: monoclonal antibody, clinical application, antibody classes
Advances in EGFR monoclonal antibody targeting drugs for glioma
Gliomas are common primary brain tumors, mainly caused by carcinogenesis of brain and spinal cord keratinocytes, while epidermal growth factor receptor (EGFR) plays an important regulatory role in cell proliferation. When the EGFR gene mutation occurs in the body, it will cause the tumor cell proliferation to be out of control. At this time, inhibition and intervention of the patient's EGFR become an important measure to control the tumor.
Gliomas are one of the common clinical tumors, which have different effects on the health and life safety of patients. Therefore, analyzing the tumorigenesis mechanism of patients and giving them proper treatment has become our focus. At present, with the continuous development of molecular targeted therapy, most scholars have already recognized its practical use value. Therefore, molecular targeted therapy in glioma treatment has become an important means to block patients' downstream signaling pathways after medication, and then to patients. The killing factor in the body is contained, the progress of the tumor is controlled, and the patient is prolonged without disease progression and survival. It is believed that with the deepening of the research, the monoclonal antibody-targeted drug can achieve more significant clinical effects.
Anti-cancer stem cell monoclonal antibody
The traditional treatment methods for gastric cancer are mainly surgery and radiotherapy and chemotherapy. However, it has not achieved a good therapeutic effect. The 5-year relative survival rate of patients has been hovering between 20% and 30% in the past. An important reason for the high mortality rate of gastric cancer is that gastric cancer cells can undergo deep invasion and metastasis of lymph, liver and abdominal cavity. Tumor stem cells are a small number of cancer cells that exist in tumor cells and have the potential for self-renewal and non-directional differentiation, and can induce the formation of heterogeneous tumors. Therefore, targeting tumor stem cells to treat tumors provides a better treatment idea for improving the 5-year survival rate of patients with gastric cancer. In the previous work, researchers have successfully established a monoclonal antibody containing 3120 anti-human gastric cancer stem cells using a technology platform of large-capacity functional monoclonal antibody library, and obtained 10 strains specifically identifying gastric cancer stem cells by cell immunofluorescence screening.
Compared with traditional surgery, radiotherapy and chemotherapy, monoclonal antibody targeted therapy has high affinity, low toxicity, can effectively treat metastasis, recurrence, and is not easy to produce drug resistance. The research on targeting tumor stem cells to treat tumors started late and its treatment plan targeting tumor stem cells may have great application potential for refractory metastasis and recurrence that currently leads to clinical death. Therefore, it has become the latest research hotspot of targeted therapy for cancer.
Antibody-conjugated drug
In the past few years, antibody drugs have developed rapidly. The antibody-conjugated drug is produced by coupling a biologically active small molecule drug to a monoclonal antibody (mAb) via a linker. At present, most of the ADCs are coupled with high-efficiency cytotoxic small molecule chemical drugs through an antibody that targets tumor antigens, and the small molecule drugs are targeted to the tumor by utilizing the specific binding of the antibody to the target antigen. The cells then play a role in killing the tumor. Compared with antibody drugs, ADC usually kills target cells more efficiently. Of course, the design of ADC is more complicated than that of antibodies. It is necessary to consider the three components of antibodies, linkers, small molecule drugs and their reasonable combination. The selection of antibodies is the starting point of ADC design and one of the decisive factors for ADC indication selection. Target antigens should generally have tumor or disease-related and high-level expression characteristics; linkers should be stable enough during ADC systemic circulation. And after reaching the surface of the target cell or entering the target cell, the small molecule drug can be effectively released in the form of high-efficiency activity; the small molecule drug should have an effective killing effect on the tumor cell.
Prospects for the development of monoclonal antibodies
In the past few years, antibody classes have developed rapidly, and the effect on drug treatment has gradually improved. Monoclonal antibody drug antibodies are mainly synthesized by B lymphocytes, and therapeutic monoclonal antibody drugs can be well adapted to the patient's condition and physical condition, but there are some precautions that need to be taken seriously. For example, Abciximab in monoclonal antibody drugs can be applied to the treatment of cardiovascular diseases, but the platelets should be accurately detected before and during treatment, and the results of the tests will be affected by factors such as acute thrombocytopenia. Therefore, it is very important to do a clinical test of monoclonal antibody drugs. The therapeutic monoclonal antibody drug can realize the hybridization of the single B lymphocytes producing the antibody with the bone marrow tumor cells, and obtain the hybrid cells which can produce the antibody and can proliferate in an endless manner, and produce the antibody, which is of great significance for the development of medical technology. . Monoclonal antibody drugs have a good clinical application, but some drugs should pay attention to the examination before and during use to ensure that the efficacy of the drug is reflected. In addition, if the process of achieving monoclonal antibody production service can be accelerated, it will be of great significance to the entire medical and clinical fields.
References
[1] Glenn C, Conner AK, Rahimi M, et al. Common Disconnections in Glioma Surgery: An Anatomic Description. Cureus, 2017, 9(10): e1778.
[2] Molina-Castro S, Pereira - Marques J , Figueiredo C , et al. Gastric cancer：Basic aspects [J]. Helicobacter,2017, 22(Suppl1). doi:10. 1111/hel. 12412