抗体药物的发展与应用

早期抗体药物是鼠源单克隆抗体,存在免疫原性强、半衰期短等问题。历经数十年的发展,抗体药物从最初的鼠源单抗,逐步发展为人鼠嵌合抗体、人源化抗体及全人源化抗体。通过片段重组、位点修饰、药物偶联等方法,科研人员研发了包括抗体融合蛋白、抗体偶联药物、双特异性抗体、小分子抗体片段等形式多样的抗体药物。抗体药物在恶性肿瘤、自身免疫病、感染性疾病的治疗上发挥重要作用。通过对抗体药物人源化历程,不同类型的抗体结构和特点,以及抗体药物在新型冠状病毒肺炎治疗中的应用进行综述,并对抗体药物的发展前景进行展望,以期为我国抗体药物的研发提供参考。     

治疗性抗体药物差异化研发策略

治疗性抗体药物在临床上取得了巨大的成功,然而在有效性和安全性方面还有待提高,同时药物靶点过于集中造成了重复开发、资源浪费等问题。因此,医药企业在研发抗体药物时需要探寻差异化的研发策略,从而在激烈的市场竞争中生存和发展。文中从药物的来源、结构形式、靶点选择、药物作用机制和差异化药物特性等方面探讨了治疗性抗体药物的差异化研发策略。     

抗体药物现状及发展趋势

治疗性抗体作为一种具有独特优势的生物靶向治疗药物,已成为目前全球药物研发的热点。截止到2013年2月,已有34个治疗性抗体获得美国FDA批准上市,用于各种疾病的治疗。据统计,目前有多达350余种抗体产品正处于临床试验阶段,其中29个已进入III期临床试验。开发抗体新靶点和新适应证,研究和设计更为安全有效的新型抗体分子及抗体组合疗法,寻找生物标记指导抗体对病人的有效治疗,是当前和今后一段时期内该领域发展的主要方向。本文将综述国际抗体药物研发现状和发展趋势,并对国内抗体药物现状及发展策略予以简要陈述。     

治疗性抗体半衰期改造研究进展

随着治疗性单克隆抗体在临床治疗方面发挥的作用日益突显,其全球药物市场所占份额和研发投入均在逐年增加。除了抗体新药的开发,抗体药物效力和安全性相关的基因工程改造也越来越受到重视。在这些基因工程改造中,抗体半衰期改造已成为近年来研究的热点之一。对几种抗体半衰期改造技术进行了介绍,并简要描述了半衰期改造后抗体的临床研究现状。     

我国抗体药物产业化发展的策略探讨

随着重组抗体药物展示出良好的治疗效果和市场效益,抗体药物的研发逐渐成为生物医药产业发展的主要方向。但是目前国内动物细胞表达水平普遍较低和发酵工艺落后的现状制约了我国抗体药物产业化的发展。主要综述了国际抗体药物产业的发展态势,重点比较二氢叶酸还原酶和谷氨酰胺合成酶表达体系、连续灌注和流加培养发酵模式的各自优势,结合我们抗体药物表达、发酵方面的经验,对当前我国抗体药物产业化发展策略进行了探讨,提出抗体药物产业化模式应根据企业对抗体产率、产能和市场经济学的多重考虑选择发酵工艺和发酵规模,应用谷氨酰胺合成酶/CHO-K1表达系统和连续灌注培养工艺可能更适应目前中国抗体产业化的需要。     

治疗性单抗与抗体产业关键技术

抗体技术历经动物血清多克隆抗体、杂交瘤单克隆抗体,以及重组基因工程抗体等不同发展时期,尤其是后者使得治疗性抗体的生产进入产业化阶段.在已上市的抗体药物中,人源化抗体、全人源抗体由于免疫原性小,临床药效好,目前已经成为抗体药物的主流.随着抗体药物在癌症、免疫调节等治疗领域的广泛应用.抗体产业已经成为国际制药行业的主要组成部分.我国的抗体产业由于品种不足、技术落后,尚处于起步阶段,其行业发展受限于诸多技术瓶颈,如:工程细胞系构建与筛选、大规模培养工艺开发,单抗的纯化与质控等,上述产业化关键技术的突破可加快我国抗体产业的发展进程.     

抗体偶联药物国内研发现状及企业布局分析

抗体偶联药物(antibody-drug conjugates,ADC)由单克隆抗体和小分子细胞毒药物通过连接子偶联而成,因在血液瘤、实体瘤等临床治疗中被证明是一种极有前景的技术手段,已经成为国内外抗体药物研发的新热门方向。系统阐述了ADC药物开发及工业化生产中的核心五要素,对国内ADC的研发管线进行了梳理,并对参与ADC研发的核心企业的技术布局情况进行了分析,以期为相关企业的ADC研发方向选择及地区产业决策提供参考。     

基因工程抗体研究进展

临床治疗中人抗鼠抗体反应的出现使鼠源性单克隆抗体的应用受到了极大的限制。为降低其免疫原性,人们利用基因工程技术对鼠源抗体进行改造,以减少其鼠源成分。简要概述了目前研究比较多的几种基因工程抗体及其临床应用。     

噬菌体抗体库技术在肿瘤抗体药物研究中的进展及应用

目的:综述噬菌体抗体库技术的研究进展,介绍该技术的原理,构建,筛选和应用,为抗肿瘤抗体药物研发提供参考。方法:采用文献综述的方法,筛选近5年来噬菌体抗体库技术试验论文,对噬菌体抗体库技术的原理,构建,筛选和应用进行总结。结果:噬菌体抗体库主要分为免疫抗体库和非免疫抗体库两大类;噬菌体抗体库筛选技术包括亲和筛选、细胞筛选和生物体内筛选三种;噬菌体抗体库技术主要应用于肿瘤标志物的识别和肿瘤诊断,抗肿瘤抗体药物的筛选和制备。结论:噬菌体抗体库技术方便、快速、高效,可以在体外环境下培养,这些特点决定了其在肿瘤标志物的发现和肿瘤抗体药物研发中的广泛应用。目前噬菌体抗体库技术还存在一定缺陷,但技术的不断发展和革新必然使噬菌体抗体库技术成为研制抗体药物的新思路,极大促进了肿瘤抗体药物的研发。     

抗新型冠状病毒单克隆中和抗体药物研发进展*

随着新型冠状病毒肺炎(COVID-19)疫情在全球的不断蔓延,开发有效的治疗药物迫在眉睫。中和抗体作为最有希望的新型冠状病毒特异性治疗药物,已经在临床研究中展现很好的治疗效果。对抗新冠病毒单克隆中和抗体药物研发的进展、涉及的主要技术和主要临床试验结果进行了总结,以期为包括COVID-19在内的新发、突发传染病中和抗体药物研发提供参考。     

Scientific and regulatory considerations on the immunogenicity of biologics

Immune responses against non-vaccine biologics can affect their efficacy and safety, resulting in adverse events that could include administration reactions, hypersensitivity, deficiency syndromes and lack of a clinical response in treated patients. With the relatively recent development of numerous biologics, immunogenicity testing has become a key component in the demonstration of clinical safety and efficacy; in fact, it is highly unlikely that regulatory approval would be granted for a biologic without an assessment of its immunogenicity. However, recommendations from regulatory agencies regarding the requirements for when and how to carry out immunogenicity testing are dispersed among numerous guidance documents. To enable the evaluation of the effects of immunogenicity on safety and efficacy, the authors have consolidated recommendations from the regulatory guidelines, and present current approaches and future directions for the assessment of immunogenicity.     

Development and characterization of an anti-rituximab monoclonal antibody panel

During the development of monoclonal antibodies (mAbs) and other therapeutic proteins, immunogenicity, in particular the induction of anti-drug antibodies (ADAs), is an important concern, and thus immunogenicity assessment is a requirement for their approval. Establishment of appropriate methods for detecting and characterizing ADAs is necessary for immunogenicity assessment, but the lack of commonly available reference standards makes it difficult to compare and evaluate the methods. It is also difficult to compare the data with those obtained by other methods or facilities without reference standards. Here, we developed a panel of ADAs against anti-CD20 rituximab (Rituxan®, MabThera®); the panel consisted of eight clones of recombinant human-rat chimeric mAbs that target rituximab. The anti-rituximab mAbs showed different binding properties (specificity, epitope and affinity), and different neutralization potencies for CD20 binding, complement-dependent cytotoxicity and antibody-dependent cell-mediated cytotoxicity. The molecular size of the immune complex consisting of rituximab and the anti-rituximab mAb differed among the clones, and was well correlated with their level of Fcγ-receptor activation. These results suggest that the ADAs chosen for the newly developed panel are suitable surrogates for human ADAs, which exhibit different potential to affect the efficacy and safety of rituximab. Next, we used this panel to compare several ADA-detecting assays and revealed that the assays had different abilities to detect the ADAs with different binding characteristics. We conclude that our panel of ADAs against rituximab will be useful for the future development and characterization of assays for immunogenicity assessment.     

The application of ICH S6 to the preclinical safety evaluation of plasma derivative therapeutic products

The ICH S6 guidance was developed to describe a rational science-based flexible approach to the preclinical evaluation for biotechnology-derived pharmaceutical products. It also suggested that some of the principles described may be suitable for plasma-derived therapeutics. Some of the specific concerns unique to protein-based therapeutics include complexity in structure and potential immunogenicity. S6 has been interpreted by some industry and regulatory authorities, often due to lack of experience with these types of products, as encouraging a broader or more conventional toxicology program similar to that normally conducted for small molecules. The guidance does encourage important and necessary preclinical evaluations but also recognizes the limitations of studies in non-relevant animal species because they are without pharmacological interaction with the biologic. In addition, studies of human proteins are often limited in useful chronic, reproductive and carcinogenic toxicity evaluations by the immunological response in animals. Thus the safety evaluation of biopharmaceuticals and plasma derivatives in animals has limitations that cannot be adequately addressed by the use of testing paradigms used for small molecule pharmaceuticals. S6 focuses evaluations on well-designed studies in relevant species for reasonable time periods to make the best use of available resources and enable clinical trials.     

WHO/Health Canada meeting on regulatory considerations for evaluation and licensing of new meningococcal Group B vaccines,Ottawa, Canada, 3–4 October 2011

Serogroup B Neisseria meningitides (MenB) is a significant cause of endemic and epidemic outbreaks of the disease worldwide. Although polysaccharide and conjugate vaccines are available against other meningococcal serogroups, the poor immunogenicity of MenB polysaccharide has led to the development of protein-based vaccines. However, the diversity and antigenic variability of MenB strains has been a major challenge. Recently a new generation of MenB vaccines that contain conserved antigens has been developed to provide broader coverage and they are in an advanced stage of development and regulatory consideration. In October 2011, the World Health Organization and Health Canada jointly organized a consultation on regulatory considerations for the evaluation and licensing of new MenB vaccines. The aim was to seek consensus on key regulatory issues relevant to the evaluation of candidate MenB vaccines and on approaches to the standardisation of in vitro assays used in the evaluation process. Participants agreed that functional antibodies as measured in the Serum Bactericidal Activity (SBA) assay could be used to evaluate MenB vaccine efficacy and ways of improving assay standardization proposed. Approaches to bridging SBA data to large collections of strains in order to give an indication of the prospective breadth of vaccine coverage were discussed.     

Salmon fibrin glue in rats: Antibody studies

Fibrin sealants and topical thrombin preparations are often used for haemostatic and sealing applications in clinical practice. Some of these preparations contain coagulation factors from bovine sources. To minimize the risk of infection and immunogenicity connected with mammalian blood products, proteins derived from the plasma of farmed Atlantic salmon have been considered as an alternative to these mammalian sources. The purpose of this study is to characterize the immunogenicity of salmon fibrin glue in an animal model focusing on crossreactivity of IgG antibodies to host endogenous counterparts. After two immunizations with salmon fibrin glue, rats developed antibodies of IgG and IgM type to both fibrin glue components. Weak crossreactivity to endogenous fibrinogen and thrombin was seen in a subset of rats after the second application of salmon proteins. Coagulation tests showed that salmon fibrin application has no effect on coagulation profiles in mammalian hosts, consistent with previous reports that found no evidence of significant crossreactivity with host proteins. These studies support the potential suitability of salmon fibrin glue for the development of preparations with clinical impact. Before human use can be considered, however, additional data about safety of this preparation in other animal models, including large animal studies, should be obtained.     

A risk-based bioanalytical strategy for the assessment of antibody immune responses against biological drugs

Bioanalytical assessments of anti-drug antibodies (ADAs) provide an understanding of the immunogenicity of biological drug molecules. The potential to induce ADAs after treatment with biologics is a safety issue that has become an important consideration in the development of biologics and a critical aspect of regulatory filings. US and European regulatory agencies are recommending that sponsors study immunogenicity using a risk-based approach, encouraging sponsors to formulate and implement their own risk management plans and to conduct discussions with the agencies when necessary. It follows from this that the greater the safety risks of ADAs, the more diligently one should clarify the immunogenicity of the product. Here we propose a general strategy to broadly assign immunogenicity risk levels to biological drug products, and present risk level-based 'fit-for-purpose' bioanalytical schemes for the investigations of treatment-related ADAs in clinical and nonclinical studies.     

Regulatory considerations in oncologic biosimilar drug development

Biosimilar monoclonal antibodies are being developed globally for patients with different types of solid tumors and hematologic malignancies. Applications for proposed biosimilar monoclonal antibodies are being submitted to the regulatory authorities around the world and may increase patient access to key treatment options upon approval. An understanding among stakeholders (e.g., physicians, patients and their caregivers, pharmacists, payers) of the approval criteria, as well as the similarities and differences in regulatory pathways involved in biosimilar approval in different countries, as presented in this review, will facilitate identification of high-quality, safe, monoclonal antibodies that have been developed according to strict, biosimilar regulatory standards. Further guidance and resolution of the ongoing discussions on biosimilar labeling, naming, automatic substitution, and indication extrapolation may ensure, in the future, an effective and appropriate use of biosimilar monoclonal antibodies by oncologists and other stakeholders in daily clinical practice.     

The prediction of immunogenicity of therapeutic proteins

Immunogenicity of therapeutic proteins is a nightmare for industrials because induced antibodies can neutralize the therapeutic activity and provoke autoimmune symptoms. It was believed that sequence humanization would be sufficient to tackle these problems but multiple clinical examples now demonstrate that humanization does not suffice to abrogate immune responses. In order to predict immunogenicity of therapeutic proteins, different approaches have been developed, among which the most relevant ones are based on the evaluation of the response of na?ve CD4 T lymphocytes specific for therapeutic proteins. Other approaches also exist or are in development. This review is the state of art in the different technologies that are proposed to predict immunogenicity of therapeutic proteins.