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Still the most comprehensive reference source on the development, production and therapeutic application of antibodies, this second edition is thoroughly updated and now has 30% more content. Volume 1 covers selection and engineering strategies for new antibodies, while the second volume presents novel therapeutic concepts and antibodies in clinical study, as well as their potential. Volumes 3 and 4 feature detailed and specific information about each antibody approved for therapeutic purposes, including clinical data. This unique handbook concludes with a compendium of marketed monoclonal antibodies and an extensive index. Beyond providing current knowledge, the authors discuss emerging technologies, future developments, and intellectual property issues, such that this handbook meets the needs of academic researchers, decision makers in industry and healthcare professionals in the clinic.

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Table of Contents

Cover

Related Titles

Title Page

Copyright

Quick Reference List of Antibodies by International Nonproprietary Name

Quick Reference List of Antibodies by Brand Name

A Greeting by the Editors

Foreword to the First Edition

Foreword to the Second Edition

List of Contributors

Abbreviations

Appendix: Marketed Monoclonal Antibodies Compendium

Volume I: Def ining the Right Antibody Composition

Chapter 1: Therapeutic Antibodies – from Past to Future

1.1 An Exciting Start – and a Long Trek

1.2 The Gold Rush

1.3 Success and Setbacks

1.4 The Gleaming Horizon

References

Further Reading

Part I: Selecting and Shaping the Antibody Molecule

Chapter 2: Selection Strategies for Monoclonal Antibodies

2.1 Introduction

2.2 Historical Remarks

2.3 Antibody Structure and Function

2.4 Production of Monoclonal Antibodies

2.5 Purification and Modification of Monoclonal Antibodies

2.6 Monoclonal Antibodies for Tumor Therapy

2.7 Outlook

References

Chapter 3: Antibody Phage Display

3.1 Introduction

3.2 Phage Display

3.3 Selection and Screening

3.4 Phage Display Vectors

3.5 Phage Display Libraries

3.6 Construction of Phage Display Libraries

Acknowledgments

References

Chapter 4: Transgenic Animals Derived by DNA Microinjection

4.1 Introduction

4.2 Construction of Human Ig Transloci

4.3 BAC Integration

4.4 Designer Zinc Finger Endonucleases to Silence Endogenous Ig Loci

4.5 Expression Comparison of Fully Human and Chimeric IgH Loci

4.6 Outlook

References

Chapter 5: Humanization Strategies

5.1 Introduction

5.2 History of Humanization

5.3 CDR-Grafting

5.4 The Design Cycle

5.5 Other Approaches to Antibody Humanization

References

Chapter 6: Antibody Affinity

6.1 Introduction

6.2 Affinity Maturation

6.3 Antibody Affinity: Antigen Binding and Potency

6.4 Binding and Potency

In Vitro

6.5 Binding and Potency

In Vivo

6.6 Selection of High-Affinity Antibodies from Hybridoma Cell Lines

6.7 Generation of Antibodies against Soluble Antigens

6.8 Generation of Antibodies against Cell Surface Antigens

6.9 Determination of Antibody Affinity

6.10 Surface Plasmon Resonance

6.11 Other Methods for Determining Antibody Affinity

6.12 Conclusion

References

Chapter 7: Fc Engineering

7.1 Mechanisms of Action of Monoclonal Antibodies

7.2 Modifying Effector Functions

7.3 Modifying Antibodies' Pharmacokinetics

7.4 Summary and Conclusions

References

Chapter 8: Glycosylation of Antibody Molecules

8.1 Introduction

8.2 Overview of the IgG Molecule

8.3 Quaternary Structure of IgG-Fc: The Protein Moiety

8.4 The IgG-Fc Oligosaccharide Moiety

8.5 IgG-Fc Protein/Oligosaccharide Interactions

8.6 Protective Mechanisms Activated by Immune Complexes

8.7 Role of IgG Glycoforms in Recognition by Cellular FγRs

8.8 The Influence of Fucose and Bisecting

N

-Acetylglucosamine on IgG-Fc Activities

8.9 The Influence of Galactosylation on IgG-Fc Activities

8.10 Sialylation of IgG-Fc Oligosaccharides

8.11 Chemo-Enzymatic Synthesis of Novel IgG-Fc Glycans

8.12 Restoration of Functionality to Aglycosylated IgG-Fc

8.13 IgG-Fab Glycosylation

8.14 Conclusion

References

Chapter 9: Bioinformatics Tools for Analysis of Antibodies

9.1 Introduction

9.2 Numbering Schemes for Antibodies

9.3 Definition of the CDRs and Related Regions

9.4 Antibody Sequence Data

9.5 Antibody Structure Data

9.6 Screening New Antibody Sequences

9.7 abYsis – An Integrated Antibody Sequence and Structure Resource

9.8 Antibody Structure Prediction

9.9 Sequence Families

9.10 Summary

References

Websites

Chapter 10: How to Use IMGT® for Therapeutic Antibody Engineering

10.1 Introduction

10.2 Fundamental Information from IMGT-ONTOLOGY Concepts

10.3 IMGT

®

Tools and Databases

10.4 Examples of IMGT

®

Web Resources for Antibody Engineering and Humanization

10.5 Conclusions

Acknowledgments

Abbreviations

References

Website

Part II: Modified Antibodies

Chapter 11: Bispecific Antibodies

11.1 Introduction

11.2 The Generation of Bispecific Antibodies

11.3 Bispecific Antibodies and Retargeting of Effector Cells

11.4 Bispecific Antibodies and Retargeting of Effector Molecules

11.5 Dual Targeting Strategies with Bispecific Antibodies

11.6 Bispecific Antibodies and Somatic Gene Therapy

11.7 Outlook Update

References

Chapter 12: Single-Domain Antibodies: An Overview

12.1 Introduction

12.2 Historical Perspective

12.3 How are sdAbs Isolated?

12.4 Target Space

12.5 Bi-specifics and Targeted Payloads

12.6 Pharmacokinetics/Biodistribution and Half-Life Extension Technologies

12.7 Imaging

12.8 Outlook

Acknowledgments

References

Chapter 13: Antibody–Drug Conjugates: New Frontier in Cancer Therapeutics

13.1 Introduction

13.2 Currently Approved ADCs for Cancer Treatment

13.3 Cytotoxic Compounds in ADCs

13.4 Linkers in ADCs

13.5 Antibody in ADCs

13.6 Conclusions

References

Chapter 14: Antibody-Targeted Drugs: From Chemical Immunoconjugates to Recombinant Fusion Proteins

14.1 Introduction

14.2 Lessons Learned from Chemical Immunoconjugates

14.3 Recombinant Cytotoxic Fusion Proteins

References

Part III: Emerging Technologies

Chapter 15: Emerging Technologies for Antibody Selection

15.1 Introduction

15.2 Display Technologies

15.3 Antibody Libraries

15.4 Antibody Selection and Maturation

In vitro

15.5 Linking Antibodies to mRNA: Ribosome and mRNA Display

15.6 Advantages of Ribosome Display

15.7 Ribosome Display Systems

15.8 Antibody Generation by Ribosome Display

15.9 Summary

References

Chapter 16: Anti-Idiotypic Antibodies

16.1 Introduction

16.2 Basic Concepts

16.3 Physiological Role of Anti-idiotypic Antibodies

16.4 Anti-Idiotypic Antibody Responses

16.5 Anti-Idiotypic Antibodies in Cancer

16.6 Anti-idiotypic Antibodies in Other Diseases

16.7 Concluding Remarks

References

Chapter 17: Non-Antibody Scaffolds as Alternative Therapeutic Agents

17.1 Introduction

17.2 Motivation for Therapeutic Use of Alternative Binding Proteins

17.3 Single Domain Immunoglobulins

17.4 Scaffold Proteins Presenting a Contiguous Hypervariable Loop Region

17.5 Scaffold Proteins for Display of Individual Extended Loops

17.6 Scaffold Proteins Providing a Rigid Secondary Structure Interface

17.7 Non-Antibody Scaffolds Stepping into the Clinic

17.8 Conclusions and Outlook: Therapeutic Potential and Ongoing Developments

References

Chapter 18: Antibody-Directed Enzyme Prodrug Therapy (ADEPT)

18.1 Introduction and Basic Principles of ADEPT

18.2 Pre-clinical Studies

18.3 Clinical Studies

18.4 Immunogenicity

18.5 Important Considerations/Outlook

Acknowledgments

Abbreviations

References

Chapter 19: Engineered Antibody Domains as Candidate Therapeutics

19.1 Introduction

19.2 eAd Structure and Function

19.3 eAd Libraries

19.4 eAds against HIV-1

19.5 eAds Targeting Cancer

19.6 eAds against Inflammation

19.7 eAds against Hematological Disorders

19.8 Conclusions

Acknowledgments

References

Chapter 20: Chimeric Antigen Receptors – “CARs”

20.1 Introduction

20.2 Chimeric Antigen Receptors – “CARs”

20.3 Preclinical Studies

20.4 Therapeutic Considerations

20.5 Perspectives

20.6 Conclusions

References

Chapter 21: Emerging Alternative Production Systems

21.1 Introduction

21.2 Production Systems

21.3 Outlook

Abbreviations

References

Volume II: Clinical Development of Antibodies

Part IV: The Way into the Clinic

Chapter 22: Process Development and Manufacturing of Therapeutic Antibodies

22.1 Introduction

22.2 Upstream Processing

22.3 Downstream Processing

22.4 Formulation Development

22.5 Commercial Manufacturing Processes

22.6 Analytics

22.7 Overall Process Development Strategies and Outlook

Acknowledgments

References

Chapter 23: The Immunogenicity of Therapeutic Antibodies

23.1 Introduction

23.2 Immunogenicity and the Immune System

23.3 Factors Influencing Immunogenicity

23.4 Clinical Consequences of Immunogenicity of Abs

23.5 Bioanalytical Assessment of ADAs against Therapeutic Antibodies

23.6 Immunogenicity Prediction Tools

23.7 Reduction of Immunogenicity of Abs

23.8 A Look into the Future – The Rise of Antibody-Based Drugs

23.9 Conclusions

References

Chapter 24: Biosimilar Monoclonal Antibodies

24.1 Introduction

24.2 EU Approach to Biosimilars

24.3 US Biosimilars

24.4 Follow-On Monoclonal Antibodies in Emerging Markets

24.5 Technical Development and Analytical Characterization of Biosimilar Monoclonal Antibodies

24.6 Non-Clinical and Clinical Development of Biosimilar Monoclonal Antibodies/Pharmacovigilance and Risk Management

Acknowledgments

Abbreviations

References

Chapter 25: Patent Issues Relating to Therapeutic Antibodies

25.1 Why Patents Matter

25.2 Types of Patent Protection in the Field of Therapeutic Antibodies

25.3 Freedom to Operate

25.4 Protecting New Developments

25.5 Management of Own and Third-Party Patents

25.6 Patent Exploitation Options and Business Models

25.7 Outlook

25.8 Reference Materials and Further Reading

Part V: Therapeutic Antibody Pipeline

Chapter 26: Monoclonal Antibody Cancer Treatments in Phase III Clinical Trials

26.1 Introduction

26.2 Antibodies for Use in Lymphoma and Related Diseases

26.3 Anti-EpCAM Antibodies: A Lesson in History and What Remains

26.4 Antibodies Against Epithelial Growth Factor Targets

26.5 Insulin-Like Growth Factor Type I Receptor Antibodies

26.6 Antibodies for Use in Renal Cell Carcinoma

26.7 Antibodies for Use in Ovarian Cancer

26.8 Blockage of Immunological Checkpoints

26.9 Miscellaneous Diseases and Targets

26.10 Summary

References

Chapter 27: Antibodies in Cancer Treatment: Early Clinical Development

27.1 Introduction

27.2 Harnessing Innate Immunity

27.3 Alteration of Intracellular Signaling

27.4 Immunoconjugates

27.5 The Three U's: Mechanisms of Unique, Unclear, or Unknown Function

27.6 Summary

References

Chapter 28: Targeting Angiogenesis by Therapeutic Antibodies

28.1 Introduction

28.2 Therapeutic Antibodies

28.3 Conclusion

Abbreviations

References

Chapter 29: Antibodies in Phase III Studies for Immunological Disorders

29.1 Introduction

29.2 Antibody Targets in Phase III Trials

29.3 Summary

References

Chapter 30: Monoclonal Antibodies in Phase 1 and 2 Studies for Immunological Disorders

30.1 Introduction

30.2 General Overview of the Immune System and Key Pathways Driving Inflammatory Diseases

30.3 Review of the Major Inflammatory Diseases Targeted by mAbs, Goals of Current Therapies and How These Might Be Met by Existing and Emerging Biologics

30.4 Mechanisms of Target Modulation Utilized by Monoclonal Antibodies

30.5 Optimizing mAbs for Efficacy and Safety

30.6 Summary

References

Chapter 31: MAbs Targeting Soluble Mediators in Phase 1 and 2 Clinical Studies Immunological Disorders

31.1 Introduction

References

Chapter 32: T Cell Inhibitors in Phase 1 and 2 Clinical Studies for Immunological Disorders

32.1 Introduction

32.2 T-Cell Inhibitors

32.3 Anti-T-Cell Costimulators

References

Chapter 33: B-Cell Inhibitors in Phase 1 and 2 Clinical Studies for Immunological Disorders

33.1 Introduction

33.2 Anti-CD19

33.3 Anti-BAFF (Blys)

33.4 Anti-CD20

References

Chapter 34: Inhibitors of Leukocyte Adhesion and Migration in Phase 1 and 2 Clinical Studies for Immunological Disorders

34.1 Introduction

34.2 Inhibitors of Leukocyte Adhesion and Migration

References

Chapter 35: Toll-Like Receptor Inhibitors in Phase 1 and 2 Clinical Studies for Immunological Disorders

35.1 Introduction

35.2 Toll-Like Receptor Inhibitors

References

Chapter 36: IgE Inhibitors in Phase 1 and 2 Clinical Studies for Immunological Disorders

36.1 Introduction

36.2 IgE Inhibitors

References

Chapter 37: Complement Inhibitors in Phase 1 and 2 Clinical Studies for Immunological Disorders

37.1 Introduction

37.2 Complement Inhibitors

References

Chapter 38: mAbs Targeting Apoptosis, Angiogenesis Inhibitors, and Other mAbs in Phase 1 and 2 Clinical Studies for Immunological Disorders

38.1 mAbs Targeting Apoptosis

38.2 Angiogenesis Inhibitors

38.3 Other mAbs

References

Chapter 39: In vitro Studies and Clinical Trials about Monoclonal Antibodies Used in Infectiology

39.1 Introduction and Infectious Context

39.2 Historical of Antibodies Used in Infectiology and Previous Clinical Trials

39.3 General Mechanisms of Action

39.4 Mode of Production of Anti-Infectious Antibodies

39.5 Anti-Infectious Monoclonal Antibodies Against Bacteria and Associated Toxins

39.6 Viral Diseases and Anti-Infectious Monoclonal Antibodies

39.7 Perspectives and Future Development of Antimycotic Monoclonal Antibodies

39.8 Conclusion

Acknowledgments

Author Contributions

Funding

Transparency Declarations Sections and Conflicts of Interest

References

Chapter 40: Immunotherapeutics for Neurological Disorders

40.1 Introduction

40.2 Alzheimer's Disease

40.3 Parkinson's Disease and Dementia with Lewy Bodies

40.4 Huntington's Disease

40.5 Amyotrophic Lateral Sclerosis

40.6 Transmissible Spongiform Encephalopathies

40.7 Conclusion

Acknowledgments

References

Part VI: Gaining Marketing Approval

Chapter 41: Regulatory Considerations in the Development of Monoclonal Antibodies for Diagnosis and Therapy*

41.1 Introduction

41.2 Regulatory Authority

41.3 Chemistry, Manufacturing, and Controls Considerations

41.4 Considerations for Nonclinical Testing

41.5 Immunogenicity

41.6 Conclusions

Acknowledgments

References

Chapter 42: Regulatory Review: Clinical to Market Transition

42.1 Introduction

42.2 General Considerations for the Clinical Development of mAbs

42.3 The Need for Regulatory Validation of the Development Program

42.4 The Approach of Agencies for Clinical Review of mAb

42.5 Strategic Regulatory Options for Rapid Market Access

42.6 Pivotal Clinical Trials for mAb

42.7 Specific Considerations for Early Development Clinic Studies of mAb

References

Chapter 43: Monoclonal Antibody Nomenclature for Clinical Studies (USA)1

43.1 Elements of a Name

43.2 Sequence of Stems and Infixes

43.3 Target/Disease Class Infix

43.4 USAN Modified Designations for Monoclonal Antibodies

43.5 Required Application Information

Volume III: Approved Therapeutic Antibodies

Part VII: Approved Therapeutic Antibodies

Chapter 44: Oligoclonal and Polyclonal Antibody Preparations

44.1 Introduction

44.2 Oligoclonal Antibodies

44.3 General Questions/Concerns

44.4 Uses/Applications of Oligoclonal Antibodies

44.5 Infectious Disease

44.6 FDA/Regulatory Considerations

44.7 Polyclonal Antibodies

44.8 Production of Polyclonal Antibodies

44.9 Immunogen Properties and Preparations

44.10 Carrier Proteins for Immunogen Preparation

44.11 Choice of Animal

44.12 Adjuvants

44.13 Route of Injection

44.14 Collecting and Processing of Blood

44.15 Antibody Purification

44.16 Polyclonal Antibody Derives Therapeutics (Clinical Utility)

44.17 Recombinant Polyclonal Antibodies

44.18 Summary

References

Chapter 45: Adalimumab (Humira®)

45.1 Overview

45.2 Basic Principles of Clinical Use

45.3 Safety

45.4 Use in Approved Indications

45.5 Clinical Studies in Intestinal Behçet Disease

45.6 Clinical Studies in Uveitis

45.7 Clinical Studies in Hidradenitis Suppurativa

45.8 Early-Stage Clinical Studies in Sarcoidosis

References

Chapter 46: Alemtuzumab (Lemtrada, MabCampath)1

46.1 Overview

46.2 Basic Principles

46.3 Antibody Features and Production

46.4 Molecular Target and Target Expression

46.5 Mechanism of Cell Lysis

46.6 Immunogenicity and Antiglobulin Response

46.7 Pharmacokinetic Studies

46.8 Clinical Studies in Chronic Lymphocytic Leukemia (CLL)

46.9 Clinical Studies in Multiple Sclerosis

46.10 Clinical Studies in Other Indications

References

Chapter 47: Basiliximab (Simulect®) and Daclizumab (Zenapax®)

47.1 Background

47.2 Clinical Use in Human Organ Transplantation

47.3 Clinical Use of IL-2R Antibodies in Non-organ Transplant Conditions

47.4 Conclusion

References

Chapter 48: Belimumab (Benlysta®)

48.1 Introduction

48.2 Basic Principles

48.3 Clinical Aspects of Belimumab Therapy

48.4 Summary

List of abbreviations

References

Chapter 49: Brentuximab Vedotin (Adcetris®) for the Treatment of CD30-Positive Hematologic Malignancies

49.1 Introduction

49.2 CD30

49.3 Preclinical Activity of Brentuximab Vedotin

49.4 Clinical Development of Brentuximab Vedotin

49.5 Future Perspectives

Acknowledgments

References

Chapter 50: Canakinumab (ILARIS®)

50.1 Introduction

50.2 Production, Pharmacology, and Pharmacokinetics of Canakinumab

50.3 Clinical Trials

50.4 Outlook and Summary

References

Chapter 51: Catumaxomab (Removab) – Trifunctional Antibodies: Combining Direct Tumor Cell Killing with Therapeutic Vaccination

51.1 Introduction

51.2 Manufacturing of trAbs

51.3 The Mode of Action of trAbs in Tumor Treatment

51.4 From Bench to Bedside with the Triomab

®

trAb Family

51.5 Potential Biomarkers Along trAb Treatment Concept

51.6 Concluding Remarks

Acknowledgments

References

Chapter 52: Cetuximab (Erbitux)

52.1 Nature, Role in Disease, Biology of the Target

52.2 Origin and Development of Erbitux

52.3 Mechanism of Action

52.4 Preclinical and Clinical Results

52.5 Production

52.6 Cetuximab in Clinics

52.7 Outlook

References

Websites

Chapter 53: Denosumab (Prolia

®

)

53.1 Introduction

53.2 Clinical Studies

53.3 Guidelines of the FDA (Website of FDA) for Denosumab (Prolia)

53.4 Summary and Outlook

References

Websites

Chapter 54: Efalizumab (Raptiva)

54.1 Introduction

54.2 Development and Characterization of the Antibody

54.3 Efalizumab in the Treatment of Psoriasis

54.4 Pharmacology and Toxicology of Efalizumab

54.5 Clinical Development of Efalizumab

54.6 Health-Related Quality of Life (HRQoL)

54.7 Safety and Tolerability

54.8 Efalizumab: Reassessment of Benefit–Risk Ratio and Suspension of Marketing Authorization

References

Chapter 55: Calicheamicin Conjugates: Gemtuzumab Ozogamicin (Mylotarg), Inotuzumab Ozogamicin

55.1 Introduction

55.2 Target Antigen Selection in Therapy with ADC

55.3 Conjugate Design/Preclinical Activity

55.4 Mechanisms of Action

55.5 Potential Mechanisms of Resistance

55.6 Clinical Trials

55.7 Summary and Conclusions

References

Chapter 56: Golimumab (Simponi®)

56.1 Introduction

56.2 Characterization and Preclinical Evaluation

56.3 First-in-Humans Study

56.4 Pivotal Clinical Studies

56.5 Market Competitors

References

Chapter 57: Yttrium-90 Ibritumomab Tiuxetan (Zevalin

®

)

57.1 Introduction

57.2 Basic Principles of Radioimmunotherapy

57.3 Development and Advantages of

90

Y-Ibritumomab Tiuxetan

57.4 Preclinical and Clinical Results

57.5 Outlook

References

Chapter 58: Infliximab (Remicade®)

58.1 Antibody Characteristics

58.2 Preclinical Characterization

58.3 Pharmacokinetics

58.4 Clinical Response

58.5 Safety

58.6 Summary

References

Chapter 59: Ipilimumab (Yervoy®)

59.1 Introduction

59.2 Cytotoxic T-Lymphocyte Antigen 4 (CTLA-4)

59.3 Ipilimumab, Mechanism of Action

59.4 Pharmacokinetics

59.5 Melanoma

59.6 Prostate Cancer

59.7 Lung Cancer

59.8 Patterns of Response with Ipilimumab (Immune-Related Response Criteria)

59.9 Adverse Events

59.10 Conclusions

References

Chapter 60: Muromonab-CD3 (Orthoclone OKT®3)

60.1 Introduction

60.2 Production of mAbs

60.3 Pharmacology of Muromonab-CD3

60.4 Therapeutic Use

60.5 Cytokine Release Syndrome

60.6 Consequences of Immunosuppression

60.7 Withdrawal from the Market

References

Chapter 61: Nimotuzumab: A Humanized Anti-EGFR Antibody

61.1 Overview

61.2 Head and Neck

61.3 Glioma

61.4 Pediatric Glioma

61.5 Esophageal and Gastric Cancer

61.6 Pancreatic Cancer

61.7 Non-Small Cell Lung Cancer (NSCLC)

61.8 Concluding Remarks

References

Chapter 62: Obinutuzumab (Gazyva®), a Novel Glycoengineered Type II CD20 Antibody for the Treatment of Chronic Lymphocytic Leukemia and Non-Hodgkin's Lymphoma

62.1

In vitro

Mechanism of Action of Type I and Type II CD20 Antibodies

62.2 Generation of Obinutuzumab

62.3 Obinutuzumab is a Classical Type II CD20 Antibody

62.4 The Epitope Recognized by Obinutuzumab

62.5 CDC Activity of Obinutuzumab

62.6 Direct Cell Death Induction by Obinutuzumab

62.7 Glycoengineering of Obinutuzumab

62.8

In vitro

NK Cell and Neutrophil ADCC and Macrophage ADCP Activity of Obinutuzumab

62.9

Ex vivo

Whole Blood B-Cell Depletion by Obinutuzumab

62.10

In vivo

Activity of Obinutuzumab in Xenograft Models

62.11

In vivo

Activity of Obinutuzumab in Combination with Chemotherapy, Bcl-2, and MDM2 Inhibitors

62.12 B-Cell Depletion by Obinutuzumab in Cynomolgus Monkeys

62.13 Conclusion from Nonclinical Pharmacology Studies with Obinutuzumab

62.14 Clinical Experiences with Obinutuzumab

62.15 Early Clinical Experience with Obinutuzumab in B-Cell Lymphoma

62.16 Phase Ib and II Experience with Obinutuzumab in B-Cell Lymphoma

62.17 Phase III Studies with Obinutuzumab in B-Cell Lymphoma

62.18 Obinutuzumab in CLL: Early Experience and Ongoing Phase II Studies

62.19 Phase III Experience with Obinutuzumab: The CLL11 Trial

References

Volume IV: Approved Therapeutic Antibodies and in vivo Diagnostics

Chapter 63: Ofatumumab (Arzerra®): a Next-Generation Human Therapeutic CD20 Antibody with Potent Complement-Dependent Cytotoxicity

63.1 Introduction and Preliminary Comments

63.2 Physical and Immunochemical Characteristics of OFA Compared to RTX

63.3 Functional Characterizations

63.4 CD20: It Is certainly a Good Target, but How Well Characterized Is It?

63.5 Key Results of Clinical Trials with OFA

63.6 Summary and Future Directions

Abbreviations

63.7 Disclosures

References

Chapter 64: Omalizumab (Xolair) – Anti-Immunoglobulin E Treatment in Allergic Diseases

64.1 Introduction

64.2 The Biology of the IgE Molecule

64.3 IgE Receptors

64.4 Cell Distribution of IgE

64.5 Physiologic and Pathophysiologic Significance of IgE

64.6 The Concept of Anti-IgE-Based Treatment

64.7 Construction of the Monoclonal Anti-IgE Molecule

64.8 Efficacy

64.9 Anti-Inflammatory Effects of Omalizumab

64.10 Pharmacological Properties of Omalizumab

64.11 Adverse Effects

64.12 Indications

64.13 Contraindications

64.14 Preparation for Use

64.15 Administration

64.16 Dosing of Omalizumab

64.17 Response to Treatment

64.18 Assessment of Therapeutic Response

64.19 Monitoring of Therapy

64.20 Drug Interactions

64.21 Pregnancy and Lactation

64.22 Cost

64.23 Non-approved Diseases

64.24 Conclusions

Acknowledgments

References

Websites

Chapter 65: Palivizumab (Synagis®)

65.1 Nature, Role in Disease, and Biology of the Target

65.2 Origin, Engineering, and Humanization of the Antibody

65.3 Mechanism of Action and Preclinical Results

65.4 Production, Downstream Processing, and Galenics of the Antibody

65.5 Summary of Results from Clinical Studies

65.6 Indications and Usage

65.7 Clinical Reports after Approval

65.8 Protective Efficacy as a Function of Palivizumab Serum Concentration?

65.9 Postmarketing Experience with Regard to Adverse Events (AEs)

65.10 Toward Improved Versions of Palivizumab

65.11 Summary

Acknowledgments

Abbreviations

References

Chapter 66: Panitumumab (Vectibix®): A Treatment for Metastatic Colorectal Cancer

66.1 Introduction

66.2 Panitumumab (Vectibix)

66.3 Results from Clinical Studies

66.4 Summary and Outlook

References

Chapter 67: Pertuzumab (Perjeta®)

67.1 HER2-Positive Breast Cancer

67.2 Mechanisms of Trastuzumab Resistance

67.3 Preclinical Development

67.4 Pertuzumab Clinical Development

67.5 Pertuzumab Cardiac Safety Profile

References

Chapter 68: Ranibizumab (Lucentis): a New Anti-Angiogenic Treatment in Ophthalmology

68.1 Introduction

68.2 Ranibizumab: Clinical Studies in Retinal Disorders

68.3 Other Molecules with Anti-VEGF Effect of Clinical Use in Retinal Disorders

References

Chapter 69: Raxibacumab, Human Monoclonal Antibody against Anthrax Toxin

69.1 Introduction

69.2 Development of Raxibacumab

69.3 Demonstration of Effectiveness under the Animal Rule

69.4 Safety

69.5 Dosing

69.6 Indication

69.7 Conclusion

Abbreviations

References

Chapter 70: Rituximab (Rituxan®)

70.1 Introduction

70.2 Rituximab Clinical Data in B-Cell Lymphoma

70.3 Rituximab in Autoimmune Disorders

70.4 Development of a Subcutaneous Rituximab Formulation (Rituximab SC) in B-Cell Lymphoma and CLL

70.5 Summary and Conclusions

References

Websites

Chapter 71: Tocilizumab (Actemra®)

71.1 Introduction

71.2 Biological Activities and Signaling of IL-6

71.3 Targeting IL-6 with Monoclonal Antibodies

71.4 Targeting IL-6 in Rheumatoid Arthritis

71.5 Targeting IL-6 in Systemic-Onset Juvenile Idiopathic Arthritis

71.6 Targeting IL-6 in Castleman's Disease

71.7 Other Indications

71.8 Adverse Events Associated with Targeting the IL-6 Receptor

71.9 Current State of Play

References

Chapter 72: Trastuzumab (Herceptin®) and Ado-Trastuzumab Emtansine (Kadcyla®): Treatments for HER2-Positive Breast Cancer

72.1 Introduction

72.2 Metastatic Breast Cancer

72.3 Early Breast Cancer

72.4 Cardiac Adverse Events

72.5 Infusion-Related Reactions

72.6 Age Considerations

72.7 Patient Considerations

72.8 Dosing/Scheduling

72.9 Ado-Trastuzumab Emtansine (T-DM1), Trade Name Kadcyla

72.10 Safety and Side Effects

72.11 FDA Approval

72.12 Conclusions

References

Chapter 73: Ustekinumab (Stelara®)

73.1 Introduction

73.2 Psoriasis

73.3 Psoriatic Arthritis

73.4 Crohn's Disease

73.5 Multiple Sclerosis

73.6 Meta Analyses on Long-Term Use

73.7 Ongoing Studies, New Indications, and Outlook

References

Chapter 74: Abciximab (Reopro®), Bevacizumab (Avastin®), Certolizumab Pegol (Cimzia®), Eculizumab (Soliris®), Natalizumab (Tysabri®)

74.1 Abciximab (Reopro)

74.2 Bevacizumab (Avastin)

74.3 Certolizumab Pegol (Cimzia)

74.4 Eculizumab (Soliris)

74.5 Natalizumab (Tysabri)

References

Chapter 75: Itolizumab (Alzumab®), Mogamulizumab (Poteligeo®), and Tositumomab (Bexxar®)

75.1 Itolizumab (Alzumab)

75.2 Mogamulizumab (Poteligeo)

75.3 Tositumomab; Iodine

131

I Tositumomab (Bexxar)

References

Further Reading

Information Sources

Part VIII: In vivo Diagnostics

Chapter 76: Radiolabeled Antibodies for Diagnostic Imaging

76.1 Introduction

76.2 Oncology

76.3 Cardiology

76.4 Infection

76.5 Summary

References

Index

End User License Agreement

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Guide

Cover

Table of Contents

Foreword to the First Edition

Volume I: Def ining the Right Antibody Composition

Part I: Selecting and Shaping the Antibody Molecule

Chapter 1: Therapeutic Antibodies – from Past to Future

List of Illustrations

Figure 1.1

Figure 1.2

Figure 1.3

Figure 2.1

Figure 2.2

Figure 2.3

Figure 2.4

Figure 2.5

Figure 2.6

Figure 2.7

Figure 3.1

Figure 4.1

Figure 4.2

Figure 4.3

Figure 4.4

Figure 4.5

Figure 4.6

Figure 4.7

Figure 5.1

Figure 6.1

Figure 6.2

Figure 6.3

Figure 6.4

Figure 7.1

Figure 7.2

Figure 7.3

Figure 8.1

Figure 8.2

Figure 8.3

Figure 10.1

Figure 10.2

Figure 10.3

Figure 10.4

Figure 10.5

Figure 10.6

Figure 10.7

Figure 10.8

Figure 10.9

Figure 10.10

Figure 11.1

Figure 11.2

Figure 11.3

Figure 11.4

Figure 11.5

Figure 11.6

Figure 11.7

Figure 11.8

Figure 11.9

Figure 11.10

Figure 12.1

Figure 12.2

Figure 12.3

Figure 12.4

Figure 13.1

Figure 13.2

Figure 13.3

Figure 13.4

Figure 13.5

Figure 15.1

Figure 15.2

Figure 15.3

Figure 16.1

Figure 16.2

Figure 17.1

Figure 17.2

Figure 18.1

Figure 19.1

Figure 19.2

Figure 19.3

Figure 19.4

Figure 20.1

Figure 20.2

Figure 20.3

Figure 20.4

Figure 22.1

Figure 22.2

Figure 22.3

Figure 22.4

Figure 22.5

Figure 22.6

Figure 22.7

Figure 22.8

Figure 22.9

Figure 22.10

Figure 22.11

Figure 22.12

Figure 22.13

Figure 23.1

Figure 23.2

Figure 23.3

Figure 24.1

Figure 24.2

Figure 24.3

Figure 24.4

Figure 24.5

Figure 24.6

Figure 24.7

Figure 25.1

Figure 16.1

Figure 28.1

Figure 28.2

Figure 41.1

Figure 46.1

Figure 46.2

Figure 46.3

Figure 46.4

Figure 46.5

Figure 46.6

Figure 46.7

Figure 46.8

Figure 49.1

Figure 49.2

Figure 49.3

Figure 49.4

Figure 50.1

Figure 50.2

Figure 50.3

Figure 50.4

Figure 50.5

Figure 51.1

Figure 51.2

Figure 51.3

Figure 51.4

Figure 51.5

Figure 51.6

Figure 52.1

Figure 53.1

Figure 55.1

Figure 55.2

Figure 55.3

Figure 55.4

Figure 57.1

Figure 57.2

Figure 59.1

Figure 60.1

Figure 62.1

Figure 62.2

Figure 62.3

Figure 62.4

Figure 63.1

Figure 63.2

Figure 63.3

Figure 63.4

Figure 63.5

Figure 63.6

Figure 63.7

Figure 63.8

Figure 63.9

Figure 63.10

Figure 64.1

Figure 64.2

Figure 64.3

Figure 64.4

Figure 64.5

Figure 64.6

Figure 64.7

Figure 64.8

Figure 64.9

Figure 64.10

Figure 64.11

Figure 64.12

Figure 64.13

Figure 64.14

Figure 64.15

Figure 64.16

Figure 64.17

Figure 65.1

Figure 65.2

Figure 65.3

Figure 65.4

Figure 65.5

Figure 66.1

Figure 68.1

Figure 68.2

Figure 68.3

Figure 68.4

Figure 70.1

Figure 70.2

Figure 70.3

Figure 70.4

Figure 70.5

Figure 70.6

Figure 70.7

Figure 70.8

Figure 70.9

Figure 70.10

Figure 70.11

Figure 70.12

Figure 70.13

Figure 72.1

Figure 72.2

Figure 72.3

Figure 72.4

Figure 72.5

Figure 72.6

Figure 72.7

Figure 72.9

Figure 72.8

Figure 72.10

Figure 72.11

Figure 73.1

Figure 76.1

Figure 76.2

Figure 76.3

Figure 76.4

Figure 76.5

Figure 76.6

Figure 76.7

Figure 76.8

Figure 76.9

List of Tables

Table 1.1

Table 1.2

Table 2.1

Table 3.1

Table 3.2

Table 3.3

Table 5.1

Table 5.2

Table 7.2

Table 7.1

Table 7.3

Table 9.1

Table 9.2

Table 9.3

Table 9.4

Table 9.5

Table 10.1

Table 10.2

Table 10.3

Table 11.1

Table 11.2

Table 12.1

Table 12.2

Table 13.1

Table 13.2

Table 14.1

Table 14.2

Table 14.3

Table 15.1

Table 17.1

Table 17.2

Table 17.3

Table 17.4

Table 19.1

Table 20.1

Table 20.2

Table 20.3

Table 20.4

Table 21.1

Table 22.1

Table 22.2

Table 22.3

Table 22.4

Table 22.5

Table 22.6

Table 22.7

Table 22.8

Table 23.1

Table 23.2

Table 23.3

Table 23.4

Table 23.5

Table 24.1

Table 24.2

Table 26.1

Table 29.1

Table 29.2

Table 29.3

Table 29.4

Table 29.5

Table 29.6

Table 29.7

Table 29.8

Table 29.9

Table 29.10

Table 29.11

Table 29.12

Table 30.1

Table 30.2

Table 41.1

Table 41.2

Table 42.1

Table 42.2

Table 44.1

Table 44.2

Table 45.1

Table 46.1

Table 46.2

Table 46.3

Table 46.4

Table 46.5

Table 46.6

Table 46.7

Table 47.1

Table 47.2

Table 47.3

Table 48.1

Table 49.1

Table 49.2

Table 51.1

Table 51.2

Table 51.3

Table 51.4

Table 52.1

Table 52.2

Table 53.1

Table 56.1

Table 57.1

Table 57.2

Table 57.3

Table 57.4

Table 59.1

Table 59.2

Table 59.3

Table 59.4

Table 60.1

Table 60.2

Table 60.3

Table 60.4

Table 60.5

Table 62.1

Table 62.2

Table 62.3

Table 63.1

Table 63.2

Table 64.1

Table 64.2

Table 64.3

Table 64.4

Table 64.5

Table 64.6

Table 64.7

Table 64.8

Table 64.9

Table 64.10

Table 64.11

Table 65.1

Table 65.2

Table 65.3

Table 66.1

Table 67.1

Table 69.1

Table 70.1

Table 70.2

Table 70.3

Table 70.4

Table 70.5

Table 70.6

Table 70.7

Table 70.8

Table 71.1

Table 71.2

Table 71.3

Table 72.1

Table 72.2

Table 72.3

Table 73.1

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Cover

Antibodies have become standard therapy in many therapeutic areas including cancer, inflammation, osteoporosis, autoimmune, cardiovascular, ophthalmic and infectious diseases. Early successes in the treatment of leukemia and lymphoma by rituximab and alemtuzumab spawned the development of ofatumumab and obinutuzumab, antibodies that kill tumor cells more potently via diverse mechanisms. The cover is an artist's impression of lymphocytic leukemia cells under therapeutic antibody attack. The image was developed by Joost M. Bakker, www.scicomvisuals.com.

Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty can be created or extended by sales representatives or written sales materials. The Advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

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