Monoclonal antibodies
Monoclonal antibodies
Recombinant DNA technology has allowed for the development of monoclonal antibodies directed at such targets as other immune cells or cancer cells. Monoclonal antibodies include:
- alemtuzumab
- gemtuzumab ozogamicin
- ibritumomab tiuxetan
- rituximab
- trastuzumab.
Pharmacokinetics
Because of their large protein molecule structure, monoclonal antibodies aren’t absorbed orally. They may have a limited distribution as well as a long half-life, sometimes measured in weeks.
Pharmacodynamics
Monoclonal antibodies bind to target receptors or cancer cells and cause tumor death via several mechanisms: They may induce programmed cell death; they may recruit other elements of the immune system to attack the cancer cell; or they may deliver a dose of a toxic chemotherapy drug (gemtuzumab) or radiation (ibritumomab) to the tumor site.
Pharmacotherapeutics
Monoclonal antibodies have demonstrated activity in both solid tumors and hematologic malignancies, such as:
- non-Hodgkin’s lymphoma’rituximab and ibritumomab (target CD20 or malignant B lymphocytes)
- chronic lymphocytic leukemia’alemtuzumab (target CD52 antigen or B cells)
- acute myeloid leukemia’gemtuzumab (target CD33 antigen in myeloid leukemic cells)
- breast cancer’trastuzumab (target HER-2 protein in breast cancer cells).
Drug interactions
Although no interactions have been noted with alemtuzumab, multiple drug interactions are associated with other monoclonal antibodies.
- Ibritumomab may interfere with the actions of such drugs as warfarin, aspirin, clopidogrel, ticlopidine, nonsteroidal anti-inflammatory drugs, azathioprine, cyclosporine, and corticosteroids.
- Trastuzumab increases the cardiac toxicity associated with anthracycline administration.
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