Monoclonal antibodies
Monoclonal antibodies are laboratory-made immune proteins designed to attach to one specific target on cancer cells. Depending on the target, they can flag cancer cells for destruction by the immune system, block growth signals at the cell surface, or bring immune cells into direct contact with the cancer. They are given by infusion; flu-like reactions are common, and rarer serious complications are also possible.
How it works
Antibodies are proteins the immune system normally uses to recognize intruders. Monoclonal antibodies are copies of a single antibody, produced in the laboratory so that they all bind the same target — for example a protein found on the surface of cancer cells. "Naked" antibodies work on their own, without a drug or radioactive substance attached.
Once bound, an antibody can act in several ways. Rituximab attaches to the CD20 protein on lymphoma cells and marks them so the immune system recognizes and destroys them more readily. Other antibodies block receptors a tumor needs to receive growth signals. Still others, such as blinatumomab, grab a cancer cell with one arm and a T cell (an immune cell) with the other, bringing them together so the T cell can kill the cancer cell. Reported side effects include reactions at the needle site, fever, chills, and fatigue, and — less often — allergic reactions or cytokine release syndrome.
Used in
Stomach
C16
trastuzumab added to chemotherapy is standard in HER2-positive advanced disease
Invasive Breast Carcinoma
C50
anti-HER2 antibodies (e.g. trastuzumab) are standard in HER2-positive disease
Colon, Rectum & Anal Canal
C18-C21
anti-EGFR antibodies in RAS wild-type tumours and bevacizumab are established additions to chemotherapy