Application of analytical detection concepts to immunogenicity testing

The cut point and detection limit of any immunogenicity assay are two of the most important quantities that define the adequacy of an assay for detecting anti-drug antibodies against therapeutic proteins. To date in the immunogenicity testing literature, only the type I (alpha) error (i.e., the false positive) rate of the assay has been considered for establishing cut points. The "sensitivity" of an immunogenicity assay is usually reported as the concentration of a monoclonal or polyclonal anti-drug antibody standard corresponding to the signal at the cut point. We propose that a more traditional and rigorous analytical chemistry definition of the detection capability be utilized wherein both type I and type II (beta, false negative) error rates are considered. Specifically, the Hubaux-Vos technique of calculating cut points and limits of detection from predication intervals on calibration curves is recommended as a statistically rigorous approach. The utility of using receiver-operator characteristic curves for managing the type I and II error rates of an immunogenicity assay is also presented. In addition, we illustrate how a soluble receptor, sMUC18, for the therapeutic mAb ABX-MA1 can result in false positives by Biacore methodology. This result suggests that immunogenicity confirmatory experiments must be carefully designed, preferably with a smaller type I and II error rate than in the primary screening if an acceptable limit of detection can be maintained.