Monoclonal antibodies (mAbs) and fusion proteins directed towards cell surface targets make an important contribution to the treatment of disease. The purpose of this review was to correlate the clinical and preclinical data on the 15 currently approved mAbs and fusion proteins targeted to the cell surface. The principal sources used to gather data were: the peer reviewed Literature; European Medicines Agency 'Scientific Discussions'; and the US Food and Drug Administration 'Pharmacology/Toxicology Reviews' and package inserts (United States Prescribing Information). Data on the 15 approved biopharmaceuticals were included: abatacept; abciximab; alefacept; alemtuzumab; basiliximab; cetuximab; daclizumab; efalizumab; ipilimumab; muromonab; natalizumab; panitumumab; rituximab; tocilizumab; and trastuzumab. For statistical analysis of concordance, data from these 15 were combined with data on the approved mAbs and fusion proteins directed towards soluble targets. Good concordance with human pharmacodynamics was found for mice receiving surrogates or non-human primates (NHPs) receiving the human pharmaceutical. In contrast, there was poor concordance for human pharmacodynamics in genetically deficient mice and for human adverse effects in all three test systems. No evidence that NHPs have superior predictive value was found.
AbbreviationsADCC, antibody-dependent cellular cytotoxicity; CD, cluster of differentiation; CDC, complement-dependent cytotoxicity; CTL, cytotoxic T lymphocyte; CTLA4, cytotoxic T lymphocyte antigen 4; CMV, cytomegalovirus; DC, dendritic cell; EAE, experimental autoimmune encephalomyelitis; EGFR, epidermal growth factor receptor; EMA, European Medicines Agency; FDA, Food and Drug Administration; ICAM-1, intercellular adhesion molecule-1; LFA, lymphocyte function associated antigen; JCV, human polyoma JC virus; mAb, monoclonal antibody; NHP, non-human primate; NK, natural killer; PML, progressive multifocal leukoencephalopathy; RBC, red blood cell; SCID, severe combined immunodeficiency; SIV, simian immunodeficiency virus; SLE, systemic lupus erythematosus; TCR, T-cell receptor; USPI, United States Prescribing Information; VLA-4, very late antigen-4; WBC, white blood cell
IntroductionMonoclonal antibodies (mAb) and soluble receptors (fusion proteins) make an important contribution to the treatment of a variety of diseases. Over 30 mAb or fusion proteins have been approved for clinical use and more than 200 more are in various stages of clinical development (Dimitrov and Marks, 2009). Because species cross-reactivity is usually highly BJP British Journal of Pharmacology DOI:10.1111DOI:10. /j.1476DOI:10. -5381.2011 British Journal of Pharmacology (2012) restricted to humans and non-human primates (NHPs), mAbs directed towards human targets are usually pharmacologically inactive in rodents (Cavagnaro, 2008). As a consequence, preclinical studies with many of the mAbs or mAb-like molecules need to be conducted in NHPs (ICH, 2011). However, there are some notable exceptions, for example abatacept (...