Monoclonal antibody therapy is one of the most successful treatment strategies for cancer. Over the last two decades, several landmark drugs have been proven efficient, paving way for personalized medicine and biomarker derived treatments.

Cancer treatments using mAb drugs is achieved via various modes of action. Targeted therapy which utilizes mAbs for direct targeting of cancer cells and induction of apoptosis has been one of the most preferred therapeutic strategies. These antibody drugs can specifically bind to cells expressing tumor-specific antigens such as HER2 (Trastuzumab or Herceptin®) and CD52 (Alemtuzumab, trade name Lemtrada®), inhibit cell proliferation signaling pathways and recruit natural killer cells or complement factors. Alternatively, mAbs can be designed to target vascular and stromal components such as VEGF, VEGFR and FAP, in order to slow down tumorigenesis. For example, Bevacizumab, trade name Avastin® (anti-VEGF) can inhibit the growth of blood vessels around the tumor, thereby disrupting the tumor micro-environment and nutrient supply.

Recently, immunotherapy has emerged as a new vertical in cancer treatment after growing evidence demonstrating the immunosuppressive ability of cancer cells. Antibodies targeting immune checkpoint pathways and enabling T-cell activation, known as immune checkpoint inhibitors, have demonstrated considerable success against liquid and solid tumors in clinical trials. Ipilimumab/Yervoy® (anti-CTLA4), Nivolumab/Opdivo® (anti-PD1), and Pembrolizumab/Keytruda® (anti-PD1) are some of the first generations of approved checkpoint inhibitors.

Currently several mAbs have been approved for therapy in cancer and many are in the clinical pipeline. The future of mAb therapeutics aims at personalized combination therapies to overcome tumor heterogeneity and improve treatment efficiency.