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      The history of monoclonal antibody development – Progress, remaining challenges and future innovations

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          Abstract

          As medicine progresses into a new era of personalised therapy, the use of monoclonal antibodies to treat a wide range of diseases lies at the heart of this new forefront. Since the licencing of the first monoclonal antibody for clinical use 30 years ago, the monoclonal antibody industry has expanded exponentially and is now valued at billions of dollars.

          With major advances in genetic sequencing and biomedical research, much research into monoclonal antibodies now focuses on identifying new targets for development and maximising their efficacy for use in clinical practice. However, a balance has to be struck with regards to reducing numbers of side-effects and overall economic cost, which arguably somewhat blighted their early clinical and commercial successes.

          Nowadays, there are approximately 30 monoclonal antibodies that have been approved for use in clinical practice with many more currently being tested in clinical trials. Some of the current major limitations include: the use of inefficient models for generation, a lack of efficacy and issues of cost-effectiveness. Some of the current research focuses on ways to improve the efficacy of existing monoclonal antibodies through optimising their effects and the addition of beneficial modifications.

          This review will focus on the history of monoclonal antibody development – how it has increasingly moved away from using laborious animal models to a more effective phage display system, some of the major drawbacks from a clinical and economical point of view and future innovations that are currently being researched to maximise their effectiveness for future clinical use.

          Highlights

          • Monoclonal antibodies are the fastest growing group of pharmaceutical molecules.

          • About 30 monoclonal antibodies are currently FDA-approved for clinical use.

          • Research is now focused on their development and ways to maximize their efficacy.

          • Issues surrounding their commercial viability have yet to be fully overcome.

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          Most cited references21

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          Neonatal Fc receptor and IgG-based therapeutics.

          The majority of potent new biologics today are IgG-based molecules that have demonstrated tissue-targeting specificity with favorable clinical response. Several factors determine the efficacy of these products, including target specificity, serum half-life and effector functions via complement-dependent cytotoxicity, antibody-dependent cell-mediated cytotoxicity or drug conjugates. In this review, we will focus on the interaction between therapeutic antibody and neonatal Fc receptor (FcRn), which is one of the critical factors in determining the circulating antibody half-life. Specifically, we will review the fundamental biology of FcRn, FcRn functions in various organs, Fc mutations designed to modulate binding to FcRn, IgG-based therapeutics that directly exploit FcRn functions and tools and strategies used to study FcRn-IgG interactions. Comprehensive understanding of FcRn-IgG interactions not only allows for development of effective therapeutics, but also avoidance of potential adverse effects.
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            Therapeutic antibodies: past, present and future.

            Over the past 10 years, the market for monoclonal antibodies has grown exponentially. This focus issue brings together articles on the basic biology of antibodies and their therapeutic use, providing an overview of the latest prospects and continued challenges for the development of safe, efficient and affordable therapeutic antibodies.
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              A tale of two specificities: bispecific antibodies for therapeutic and diagnostic applications

              Highlights • Recombinant DNA technologies are leading the rapid expansion of bispecific antibody formats. • The therapeutic potential of bispecific antibodies is being realized through creative design. • Bispecific antibodies are potentially underutilized reagents for diagnostics.
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                Author and article information

                Contributors
                Journal
                Ann Med Surg (Lond)
                Ann Med Surg (Lond)
                Annals of Medicine and Surgery
                Elsevier
                2049-0801
                11 September 2014
                December 2014
                11 September 2014
                : 3
                : 4
                : 113-116
                Affiliations
                [1]Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, London, E1 2AD, UK
                Author notes
                []Tel.: +44 7929156503. j.k.h.liu@ 123456smd12.qmul.ac.uk
                Article
                S2049-0801(14)00062-4
                10.1016/j.amsu.2014.09.001
                4284445
                25568796
                a55f9a70-c47a-4d22-8bdd-1661fc82065e
                © 2014 The Author

                This is an open access article under the CC BY-NC-SA license (http://creativecommons.org/licenses/by-nc-sa/3.0/).

                History
                : 16 April 2014
                : 13 August 2014
                : 1 September 2014
                Categories
                Review

                personalised medicine,monoclonal antibodies,therapeutic antibodies,antibody development,antibody modifications

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