Protein therapeutics--lessons learned and a view of the future

Protein therapeutics represent a rapidly growing proportion of marketed drugs and have an undisputed place alongside chemistry-based oral therapies; indeed, for certain indications they are the only effective therapy. Therapeutic proteins can be mined from diverse sources to target interactions that are not accessible to small molecules, and can be engineered to have optimal pharmacological properties. Nevertheless, the development of such therapeutics is hampered by several issues, such as cost of production, patient compliance, immunogenicity and reticence of reimbursement agencies to pay for their use in chronic treatment. Herein we review some of these issues in detail. The application of technological advancements will address some of these issues and enable the development of a growing number of biological therapies that will continue to improve patient quality of life for decades to come.