Monoclonal antibodies target specific disease molecules. They can help treat cancer, autoimmune disorders, and infectious diseases. Discover what you should know about this therapy.

Monoclonal antibodies (mAbs) are a type of biologic therapy developed in 1975 by the scientists Köhler and Milstein. They are based on our own natural antibodies (also known as immunoglobulins).

mAbs can help treat many diseases and conditions, including:

  • cancer
  • autoimmune disorders
  • infectious diseases
  • transplant rejection
  • asthma
  • allergies
  • neurological conditions

Monoclonal antibodies (mAbs) offer precise, targeted treatments for a range of diseases.

They are typically given via infusion into a vein. Some are given as an injection under the skin.

Before you start treatment with mAbs, you’ll likely have tests to figure out how the cancer cells may respond. A doctor can use biopsy tissue or a blood sample to do this.

Antibodies: proteins that function like a “lock-and-key,” where the antibody (key) fits precisely into a specific antigen (lock) on a disease-causing molecule.

Monoclonal antibodies: A special type of antibody

  • Monoclonal antibodies are similar to the antibodies we produce naturally, but with one distinction: they are made in a lab.
  • This means scientists can design them to bind to a specific target in the body to help treat a particular disease.
  • They can also make them carry treatments to certain cells only. For example, they may take a cancer drug specifically to cancer cells.

mAbs can work alongside your own immune system to help the body fight problem cells. There are different ways mAbs can do this. They may also deliver treatment to particular cells, avoiding other, healthy cells.

This can be useful, for example, instead of chemotherapy, which also affects non-cancer cells.

The ways in which mAbs can help your body defend itself are vast.

Here are 5 ways mAbs work:

  • block signaling pathways: mAbs can interfere with disease progression by blocking certain signaling pathways in diseased cells. They do this by binding to specific receptors.
  • neutralization: By binding to pathogens like viruses and bacteria, mAbs prevent them from entering and infecting your cells, effectively neutralizing them.
  • activate complement: mAbs can activate a part of the immune system known as the complement system. This leads to a series of reactions that result in the destruction of the targeted cells or pathogens.
  • antibody-dependent cellular cytotoxicity (ADCC): mAbs can bind to a target cell, attracting immune cells that can then release toxic substances that kill the affected cells.
  • engage your immune system: mAbs enhance the immune response by acting as a bridge between target cells and immune cells, meaning your body can respond to the disease more strongly.

Here are some of the most common mAbs and their uses:

  • rituximab (Rituxan): non-Hodgkin lymphoma, chronic lymphocytic leukemia, rheumatoid arthritis.
  • trastuzumab (Herceptin): HER2-positive breast cancer, HER2-positive gastric cancer.
  • adalimumab (Humira): rheumatoid arthritis, psoriatic arthritis, Crohn’s disease, ulcerative colitis.
  • bevacizumab (Avastin): colorectal cancer, non-small cell lung cancer, glioblastoma, renal cell carcinoma.
  • pembrolizumab (Keytruda): melanoma, non-small cell lung cancer, head and neck squamous cell carcinoma, Hodgkin lymphoma.
  • nivolumab (Opdivo): melanoma, non-small cell lung cancer, renal cell carcinoma, classical Hodgkin lymphoma.
  • infliximab (Remicade): rheumatoid arthritis, Crohn’s disease, ulcerative colitis, psoriasis.
  • omalizumab (Xolair): severe asthma, chronic idiopathic urticaria.
  • tocilizumab (Actemra): rheumatoid arthritis, systemic juvenile idiopathic arthritis.
  • secukinumab (Cosentyx): psoriasis, psoriatic arthritis, ankylosing spondylitis.

Different types of mAbs exist:

Recombinant DNA and phage display mAbs are traditional types of mAbs.

Specialized forms of mAbs include antibody fragments and bispecific antibodies. These are developed to be even more effective and precise. An example of a bispecific mAb is blinatumomab, which can target multiple antigens.

mAbs can treat a wide range of conditions and are powerful therapeutic agents.

  • cancer: mAbs can target specific proteins on cancer cells, inhibiting growth or killing the cells directly. They are used in therapies for cancers such as breast cancer, lymphoma, and melanoma.
  • autoimmune and inflammatory diseases: Conditions like rheumatoid arthritis and Crohn’s disease benefit from mAbs that balance the immune system to reduce inflammation.
  • infectious diseases: mAbs can neutralize pathogens and can treat diseases like COVID-19 and HIV.
  • transplant rejection: mAbs can help prevent organ transplant rejection by targeting specific immune cells.
  • asthma: mAbs can target and neutralize allergens, providing relief from symptoms.
  • allergies: mAbs are also being explored for their potential in treating various allergic conditions. By targeting specific components of the allergic response, such as IgE (a specific type of antibody), these therapies aim to reduce symptoms and improve the quality of life for patients with severe allergies.
  • neurological conditions: mAbs are being explored for treating conditions like multiple sclerosis and Alzheimer’s disease.
  • rare diseases: mAbs offer new treatment options for rare and previously untreatable diseases. For example, eculizumab (Soliris) can treat paroxysmal nocturnal hemoglobinuria, a rare and life threatening blood disorder, by inhibiting the complement system.

If you are interested in finding out more about how mAbs may be able to help you and your condition, speak with your doctor. They will be able to determine if this treatment option is suitable for you.

Monoclonal antibodies (mAbs) are typically administered via intravenous (IV) infusion or subcutaneous injection. The route of administration, dosage, and frequency depend on the disease being treated, the individual patient’s needs, and the properties of the mAb.

Intravenous (IV) infusion:

  • pre-medication: To minimize the risk of infusion-related reactions, you may be given pre-medication such as antihistamines, corticosteroids, or acetaminophen before the infusion.
  • first infusion: The first dose of an mAb administered by IV infusion is usually given slowly to monitor for any immediate hypersensitivity or infusion-related reactions. This initial dose might be infused over several hours.
  • following infusions: If you have no problems with the first infusion, later treatments may be given more rapidly.

Subcutaneous injection:

  • Some mAbs are prepared for subcutaneous injection, which can be administered by healthcare professionals or self-administered by patients after proper training. Common sites for subcutaneous injection include the abdomen, thigh, or upper arm.
  • Rotating injection sites is often recommended to reduce the risk of skin reactions.

Monitoring the administration and effects of mAbs is crucial to detect any side effects and make sure the medication is working as it should.

Strategies include:

Assessment before and during treatment:

  • medical history and physical examination: A doctor will take your full medical history and give a physical examination to identify any potential risks before you start mAb therapy.
  • laboratory tests: Baseline laboratory tests may include complete blood count, liver function tests, kidney function tests, and tests for specific biomarkers relevant to the disease being treated.
  • during infusion or injection:
    • vital signs: Monitoring vital signs such as blood pressure, heart rate, and temperature during and after the infusion can help detect early signs of infusion reactions.
    • observation for immediate reactions: A doctor will monitor you for immediate hypersensitivity reactions, including rash, itching, shortness of breath, or anaphylaxis.

Post-administration monitoring:

  • regular follow-up visits: Regular follow-up visits are essential to monitor your response to treatment and to detect any side effects that may come on after the medication has been given.
  • laboratory monitoring: Periodic laboratory tests may be conducted to monitor for potential side effects, such as infections, liver or kidney dysfunction, and blood abnormalities.
  • imaging studies: When mAbs are used for cancer treatment, imaging studies like CT or MRI scans may be used to assess the cancer’s response to therapy.

Managing side effects:

  • infusion-related reactions: Mild reactions may be managed by slowing the infusion rate or administering antihistamines or corticosteroids. Severe reactions may require you to stop the infusion and have medical treatment to stop the reaction.
  • infections: People undergoing mAb therapy, especially to target parts of their immune system, have a higher risk of infections. Quick detection and treatment of infections is critical.
  • autoimmune reactions: Monitoring for signs of autoimmune reactions, such as new symptoms or worsening of existing conditions, is important if you are receiving immune-modulating mAbs.

Self-monitoring and education:

  • self-monitoring: It’s a good idea to monitor yourself for symptoms of side effects, such as signs of infection, allergic reactions, or new symptoms.
  • consistent treatment: It’s important to make sure you stick to your prescribed dosing schedules and follow-up appointments to make sure your mAb therapy is as safe and effective as possible.

The effectiveness of mAbs can vary depending on the disease being treated and the individual person. However, they can be highly effective in certain people for particular conditions.

For instance, they are highly effective in treating cancer, autoimmune conditions, and infections.

Limitations

One of the major challenges with mAbs is their cost. Access to these treatments varies globally, with developed countries having more widespread availability compared to developing regions.

Efforts are ongoing to reduce costs and increase accessibility through biosimilars and other initiatives. Clinical research also continues to explore new applications and improve existing treatments.

While monoclonal antibodies are highly effective, they are not without side effects.

Common reactions can include:

  • infusion and injection site reactions
  • fatigue
  • increased risk of infection

Long-term safety data are still being collected, but rare risks may include severe allergic reactions and autoimmune responses.

Certain groups — such as pregnant people, children, and older adults — may need tailored treatment approaches.

Read on for the answers to common questions.

A mAb is a lab-made antibody designed to target one specific molecule (antigen) in the body, helping treat diseases with high precision.

Vaccines train your body to make its own antibodies for long-term protection. mAbs are given directly and have an immediate but temporary effect (they do not stay in your body).

Most mAbs are given by IV infusion in a clinic, but some can be injected under the skin. Administration schedules range from weekly to every few months.

They are used for cancers, autoimmune diseases (like rheumatoid arthritis), asthma, migraine, high cholesterol, and infections.

Common side effects include infusion or injection reactions, fatigue, and infection risk. Serious reactions are rare but possible.

No. They are targeted therapies and may be used with chemotherapy, but work differently by aiming at specific disease molecules.

Yes, some patients may develop resistance due to changes in disease targets or immune response.

mAbs have revolutionized treatment for many diseases, offering precision where few options existed before.

New advances continue to grow their impact, but challenges remain around cost and access.

If you are considering this option, speak with your healthcare team about eligibility, risks, and access programs.