[Monoclonal antibodies, act two: new molecules for new challenges]

After early difficulties due in part to their mouse origin and questionable selection criteria, monoclonal antibodies have become major therapeutic tools thanks to more and more sophisticated molecular engineering. They are now used in a growing number of therapeutic areas. Molecular engineering has focused on the improvement of antibody affinity, the reduction of immunogenicity due to the murine origin of the first generation of monoclonal antibodies and on the increase of antibody effector properties, initially limited by their murine origin. The current success of antibodies raises new challenges that the scientific and medical communities are taking up: design of antibodies with optimized functional properties, with lower side effects, design of new molecular formats (drug-coupled antibodies, bi-specific antibodies, antibodies with optimized half-lives), detection and selection of "responder" patients. As a new antibody generation is quickly emerging, the future of antibodies is already at sight: development of oligoclonal strategies where cocktails of monoclonal antibodies are used, rationale selection of eligible patients, bulk production at lower costs. To date, twenty-three monoclonal antibodies have received an approval in the United States and/or in Europe and more than two hundred and fifty are currently evaluated in clinical trials. A new wave is coming...