Monoclonal Antibodies, Cancer, and Neurological Disease

Monoclonal antibodies can selectively target specific antigens on specific cells (and not others) as seen here. They could be very useful for personalized medicine especially in the case of cancer, which has several different pathways of emergence. Lots of patients with cancer usually undergo chemotherapy which is 1. Not specific to any cells in general and 2. Associated with lots of large risk factors and side effects. Resection is another option but isn’t always possible, and with it comes the high chance of recurrence in the same part of the body where the original tumor was found. Cancer patients also have the chance of developing resistance to their drug regimen over time, even with combination therapy . So, the use of monoclonal antibodies could be especially promising in the cancer field in combating these treatment issues by targeting cancer cells in a very selective fashion.  

In the realm of neurological disorders, the use of monoclonal antibodies has risen in the past few years for the exact same reasons as I’ve mentioned above with cancer- selective targeting and decreased side effects. Yet, as promising as the use of monoclonal antibodies (mAb) sounds, they seem to be associated with long lasting neurotoxic effects in humans as seen here.

Upon treatment with mAb, 3 multiple sclerosis (MS) patients in a study developed multifocal leukoencephalopathy. In another case, a drug directed at vascular endothelial growth factor and used in the treatment of colon and renal cancers has resulted in posterior leukoencephalopathy (though reversible) in some patients. De-myelination outside of the CNS (in MS patients) has also been seen in patients treated with mAb. Other patients using mAb therapies for neurological diseases such as MS and neuromuscular diseases as well as for cancer, have experienced brain atrophy, intracerebral brain hemorrhage, thrombocytopenic purpura, and clinical disability, etc.

Although monoclonal antibodies have the ability to target specific antigens and show promise, they currently seem to be creating more disorder than healing because we don’t know much about them.

Food for Thought:

Should we be using monoclonal antibodies?

We knew that there could be adverse effects on patients. But, what exactly is causing them? Could it be that we’re targeting proteins or organelles that play a major role in cell function?

Could mAbs be more useful in cancer treatment than in neurological disorders? Cancer cells  are usually targeted  to “be killed” not just stopped --- might not be the best idea for neuro diseases.