Monoclonal antibodies in cancer treatment: a review of recent progress

Research advances and promising clinical outcomes with immunotherapeutics has led to a resurgence of incorporating monoclonal antibodies in cancer treatment. Unconjugated, conjugated and multi-target constructs are emerging as a conventional form of therapy along with the classical trio of surgery, radiation and chemotherapy. The recent major accomplishments in monoclonals include: first, the development of human and chimeric structures negating the induction of humoral responses to murine counterparts which limited use; second, protein engineering has improved the affinity and specificity of the antibody to its target; third, technics have been designed to select monoclonal antibodies imparting a biological consequence (function) following binding; and, lastly, recombinant proteins are being created with multiple epitopic specificities and/or fusion with other biologically active proteins such as toxins and cytokines/growth factors. Clinical efficacy in the treatment of haematological malignancies has secured a role for monoclonals in routine treatment. Evidence of clinical responses in patients with metastatic solid tumours is leading to the next generation of trials in the adjuvant setting. This paper presents an overview of the clinical experience with monoclonal antibodies in cancer treatment over the past 5 years. Our aim is to highlight the successes and advances, as well as noting limitations of antibody therapeutics. The advances seen support a continued effort to optimise the creation, selection and use of immunotherapeutics in the battle against cancer.