Monoclonal Antibodies in Clinical Practice: A Breakthrough in Immunotherapy

This article discusses the use of monoclonal antibodies in immunotherapy for cancer treatment. It explains how they work and their effectiveness in curing diseases. The article also highlights the challenges of biomarkers of breast cancer and the need for personalized medicine.

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Rapid Development And Introduction Of Monoclonal Antibodies Drugs In Clinical Practice
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Reflection
The immune system in the body comprises the complex collection of cells, molecules,
and tissues that have the responsibility of defensively protecting the body against adverse
effects of microbes, toxins and other related agents (4). This defence mechanism is divided
into two categories namely; the innate and the adaptive defence mechanism. The innate
immune system is compost of the cells and proteins that are naturally present in our body (1).
They include; epithelial cells, phagocytic cells, dendritic cells, the circulating plasma cells,
and the natural killer cells. The adaptive immune system also involves the components that
are silent but get triggered when an innate immune system is overwhelmed. These
components include; the humoral immunity that is mediated by the B lymphocytes and the
cell-mediated immunity that is also mediated by T lymphocytes (1).
The chronological approach of curing diseases more especially cancer has undergone
different scientific breakthroughs like radiotherapy, chemotherapy, nutritional therapy and
surgery (5). However, some of these methods have posed detrimental ramifications in the
way they interact with the body as they lack selectivity by killing both the normal and
cancerous cells (3) The next generation of which the biomedical scientist and the
pharmaceutical industry is focusing on the cancer drugs is the issue of selectivity in a bid to
reduce the side effects that patients do experience as well as reducing drug and radiation
toxicity in the body while keeping in check the issue of drug efficacy. That approach is the
use of immunotherapy (3).
Since the body has its own defence mechanism to fight diseases, immunity of the body,
immunotherapy boosts it naturally to respond to diseases through developing antibodies,
which in turn binds with the antigenic sites of the cancerous cells(4). This binding brings
about the therapeutic effect of the anti-cancer agents that are used for its cure e.g. the use of
Trastuzumab for breast cancer. These immunotherapy approaches have simultaneous

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objectives which include to; lower the rate at which cancer cells grow, stop metastasizes of
the cancer cells and to boost the immune system (2).
The following types of immunotherapy have been researched and have been found to
be effective (1). They include; the use of T-cell therapy, the use of a monoclonal antibody,
the use of oncolytic virus therapy, the application of the non-specific immunotherapies and
the use of the third generation reverse cancer vaccines. However, the use of monoclonal
antibodies has gained much application (5).
The therapeutic approach that employs the use of monoclonal antibodies for instance,
in the cure against non-Hodgkin's lymphoma, unconjugated antibody, radioimmunoisotypes
conjugates with the CD20 which in turn reacts with tumours and selectively kills them, and
this approach have shown tremendous significance in the cure of the B-cell non-Hodgkin's
lymphoma(2). For the cure of Myeloid Leukaemia, the use of an ant-CD33 antibody that
conjugates with calicheamicin has also been recommended. Other immunotoxins that have
been of great application are the CD52 antibody has also been significantly used for the cure
against lymphatic leukaemia and the use of anti-HER2 as a cure for the breast cancer which
will be our point of focus(5).
The mode of action of these monoclonal antibodies has been widely and extensively
explained. For instance, these antibodies possess the ability to interfere with the signalling
pathway which is of great importance to sustain the malignant cells which enhance auto-
tumour antigen-specific immune responses (5).
The other mechanism of action of the monoclonal antibody is the use of antibody-
dependent cellular cytotoxicity (ADCC). In this approach, the antibodies bind with the
antigens of the cancer cells. The Fc-receptor of the antibody then reacts with the immune
cells which in turn lead to the formation of an adaptor protein that elicits the immune effector

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cells. For instance, in the case of breast cancer, ADCC elicits specific antibodies which
subsequently induce the HER2 antibodies. Another great application of the monoclonal
antibody is its effect as an adjuvant; this approach focuses on the ability of monoclonal
antibodies to recruit the adaptive cancerous cells that are antigen-specific as in the case of
HER2 for breast cancer.
In as much as this immunotherapy has shown tremendous achievements in curing
breast cancer by the use of Trastuzumab, there still remains other challenges since the
biomarkers of breast cancer, HER2 are of different subtypes. This, therefore, leads us to the
next breakthrough in medicine and that is personalized medicine. For instance, the breast
cancer HER2 can be of different subtypes that include, HER2+ Lumina A, HER2+ Lumina
B, HER- Lumina B, HER 2 enriched etc, these subtypes make patients not to respond equally
to Trastuzumab drugs. Therefore, to ensure drug efficacy that can lead to effective treatment,
there is a need to employ molecular characteristics in the genetic makeup of each biomarker
of breast cancer.

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References
1. Home | Cancer Immunology Research [Internet]. [cited 2018]. Available from:
http://cancerimmunolres.aacrjournals.org/
2. Cancer immunology - Wikipedia [Internet]. [cited 2018]. Available from:
https://en.wikipedia.org/wiki/Cancer_immunology
3. Cancer Immunology - an overview | ScienceDirect Topics [Internet]. [cited 2018].
Available from: https://www.sciencedirect.com/topics/medicine-and-dentistry/cancer-
immunology
4. Center for Cancer Immunology - Massachusetts General ... [Internet]. [cited 2018].
Available from:
https://www.massgeneral.org/cancer/services/centers/cancer_immunology.aspx
5. Cancer Immunology Named 'Breakthrough of the Year' - Medscape [Internet]. [cited
2018]. Available from: https://www.medscape.com/viewarticle/818181

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