This is a working overview of monoclonal-antibody, written for readers who want more than a one-paragraph summary but less than a textbook.
This page was last updated on 2025-06-09 and is reviewed periodically as new material appears.
The 2014 Ebola outbreak killed more than 11,300 people. In the Democratic Republic of Congo (DRC), as of January 2020, this is the second largest outbreak with over 3,400 confirmed or probable cases, including more than 2,200 deaths. Regeneron used its VelociGene, VelocImmune, and VelociMab antibody discovery and production technologies and coordinated with the U.S. government's Biomedical Advanced Research and Development Authority (BARDA). The therapy was developed in 6 months and a Phase 1 trial in healthy humans was completed in 2015.
Antibody–drug conjugates or ADCs are a class of bioconjugates and immunoconjugates. ADCs are composed of an antibody linked to a cytotoxic (anticancer) "payload" or drug. Among treatment options for cancer, chemotherapy is most widely used. Its main limitation is low target specificity. Unlike chemotherapy, ADCs target tumor cells while sparing healthy cells. As of 2019, some 56 pharmaceutical companies were developing ADCs. ADCs combine the targeting properties of monoclonal antibodies with the cancer-killing capabilities of cytotoxic drugs, designed to discriminate between healthy and diseased tissue.
Ansuvimab is a monoclonal antibody therapy that is infused intravenously into people with Ebola virus disease. Ansuvimab is a neutralizing antibody, meaning it binds to a protein on the surface of Ebola virus that is required to infect cells. Specifically, ansuvimab neutralizes infection by binding to a region of the Ebola virus envelope glycoprotein that, in the absence of ansuvimab, would interact with virus's cell receptor protein, Niemann-Pick C1 (NPC1). This "competition" by ansuvimab prevents Ebola virus from binding to NPC1 and "neutralizes" the virus's ability to infect the targeted cell.
Ansuvimab, sold under the brand name Ebanga, is a monoclonal antibody medication used for the treatment of Ebolavirus (Zaire ebolavirus) infection. The most common symptoms include fever, tachycardia (fast heart rate), diarrhea, vomiting, hypotension (low blood pressure), tachypnea (fast breathing) and chills; however, these are also common symptoms of Ebolavirus infection. Ansuvimab was approved for medical use in the United States in December 2020. It is on the World Health Organization's List of Essential Medicines. Ansuvimab is composed of a single monoclonal antibody (mAb) and was initially isolated from immortalized B-cells that were obtained from a survivor of the 1995 outbreak of Ebola virus disease in Kikwit, Democratic Republic of the Congo. In work supported by the United States National Institutes of Health and the Defense Advanced Projects Agency, the heavy and light chain sequences of ansuvimab mAb were cloned into Chinese hamster ovary cell lines and initial production runs were produced by Cook Phamica d.b.a. Catalent under contract with Medimmune.
Eculizumab (Soliris) appears to be useful for atypical hemolytic uremic syndrome (aHUS). In September 2011 the U.S. Food and Drug Administration (FDA) approved it as an orphan drug to treat people with aHUS. This approval was based on two small prospective trials of 17 people and 20 people. In the UK, NICE issued guidance on the use of Eculizumab for treating aHUS, based on five evidence sources, including those used by the FDA No randomised controlled trials were identified. All prospective studies were phase 2, open‑label, non‑randomised, single‑arm studies that included patients with different clinical baseline characteristics. The prospective studies lasted 26 weeks; however, patients were allowed to continue treatment with eculizumab in a long‑term extension study. Ravulizumab-cwvz (Ultomiris) is a second generation monoclonal antibody for aHUS made by Alexion pharmaceuticals, Inc. The target of ravulizumab-cwvz is the same eculizumab (Soliris) with changes to the structure of the antibody resulting in a longer serum half life and therefore reduced dosing regimen.
Sources: en.wikipedia.org
Antibodies have antigen-binding fragment (Fab) regions and constant fragment (Fc) regions. The Neutralization of virus infection occurs when the Fab regions of antibodies binds to virus antigen(s) in a manner that blocks infection. Antibodies are also able to "kill" virus particles directly and/or kill infected cells using antibody-mediated "effector functions" such as opsonization, complement-dependent cytotoxicity, antibody-dependent cell-mediated cytotoxicity and antibody-dependent phagocytosis. These effector functions are contained in the Fc region of antibodies, but is also dependent on binding of the Fab region to antigen. Effector functions also require the use of complement proteins in serum or Fc-receptor on cell membranes. Ansuvimab has been found to be capable of killing cells by antibody-dependent cell-mediated cytotoxicity.
Another strategy for site-specific amine conjugation to proteins is to replace lysine residues with arginine residues (LDVs). If all lysines are depleted then the only remaining free amine is at the amino terminus (N-terminus) of the protein. In the case where the protein is an antibody Fc domain, a recombinant LDV Fc can still be purified using protein A. LDV Fc proteins fused with short peptide targeting sequences can be used to deliver conjugated payloads, including nanoparticles, to specific cell surface proteins. The majority of ADCs under development or in clinical trials are for oncological and hematological indications. This is primarily driven by the inventory of monoclonal antibodies, which target various types of cancer. However, some developers are looking to expand the application to other important disease areas.
Afucosylated monoclonal antibodies are monoclonal antibodies engineered so that the oligosaccharides in the Fc region of the antibody do not have any fucose sugar units. When antibodies are afucosylated, antibody-dependent cellular cytotoxicity (ADCC) is increased. Most approved monoclonal antibodies are of the IgG1 isotype, where two N-linked biantennary complex-type oligosaccharides are bound to the Fc region. The Fc region exercises the effector function of ADCC through its interaction with leukocyte receptors of the FcγR family. ADCC is important in the efficacy of cancer antibodies, but with many approved cancer antibodies there is less ADCC than could be desired due to nonspecific IgG competing with the drugs for binding to FcγIIIa on natural killer cells. Afucosylated monoclonal antibodies overcome this problem through improved FcγIIIa binding.
Another strategy for site-specific amine conjugation to proteins is to replace lysine residues with arginine residues (LDVs). If all lysines are depleted then the only remaining free amine is at the amino terminus (N-terminus) of the protein. In the case where the protein is an antibody Fc domain, a recombinant LDV Fc can still be purified using protein A. LDV Fc proteins fused with short peptide targeting sequences can be used to deliver conjugated payloads, including nanoparticles, to specific cell surface proteins. The majority of ADCs under development or in clinical trials are for oncological and hematological indications. This is primarily driven by the inventory of monoclonal antibodies, which target various types of cancer. However, some developers are looking to expand the application to other important disease areas.
Sources: en.wikipedia.org