Monoclonal Antibodies

October 24, 2024

This page was reviewed under our medical and editorial policy by Alexis Boling, MSN-RN, CNML, director, nursing, Immune Effector Cell & Gene Therapy Program, City of Hope^® Cancer Center Duarte

Monoclonal antibodies (also called mAbs or MoAbs) are a type of immunotherapy that may be used as a treatment for cancer patients. Immunotherapy uses a patient’s own immune system to fight disease. Monoclonal antibody immunotherapy helps the immune system attack cancer cells.

What Are Monoclonal Antibodies?

The body produces blood proteins called antibodies to identify threats and mount an immune response to them. Monoclonal antibodies are man-made clones of natural antibodies. There are many kinds of monoclonal antibodies, each designed to bind with a specific protein to trigger an immune response.

Types of Monoclonal Antibodies

Three types of monoclonal antibodies are used for cancer treatment.

Naked monoclonal antibodies. The most common type, these antibodies work on their own to alert the immune system to the presence of cancer cells. They may attach to cancer cells to attract immune cells, target immune system checkpoints to boost the body’s immune response, or attach to and block the proteins that allow cancer cells to grow or spread.

Conjugated monoclonal antibodies: These antibodies are joined together with a chemotherapy or other drug (antibody-drug conjugates) or radioactive particles (radiolabeled antibodies) to deliver the treatment directly to cancer cells.

Bispecific antibodies. These are parts of two different monoclonal antibodies that work in pairs to attach to two types of targets at once. For example, one monoclonal antibody will stick to a cancer cell, while the other attaches to an immune cell to draw the two together for an efficient immune response.

How Do Monoclonal Antibodies Work?

Monoclonal antibodies help immune cells find and fight cancer cells. Each monoclonal antibody is designed to bind with a specific antigen (a substance that causes an immune response). Antigens may be certain proteins that attach to cancer cells. To determine which monoclonal antibody to create, the target antigen must first be identified.

Once the monoclonal antibodies enter a person’s bloodstream, they move through it until they find and bind with their targets. Once bound to the target, they mark the cancer cells, making it easier for the immune cells to find them. Then the monoclonal antibodies help the immune cells destroy the cancer cells or prevent the cancer cells from growing or spreading.

What Happens During Monoclonal Antibody Treatment?

During treatment, the monoclonal antibodies are usually given intravenously (into the vein) with an infusion so they have direct access to the bloodstream.

For an infusion, a thin, flexible tube called a catheter is placed through the skin into the vein. The catheter is attached to a bag that contains fluids with the monoclonal antibodies. The monoclonal antibodies are then slowly released into the bloodstream.

Side Effects of Monoclonal Antibody Drugs

Patients may have a reaction at the time of the infusion, general side effects to the treatment or side effects specific to the type of monoclonal antibodies provided.

Some possible symptoms of an infusion reaction include:

• Rashes, hives or itching
• Swelling of the tongue, lips or eyelids
• Swelling of any part of the body
• Flushing (redness) in the face and neck
• Flu-like symptoms, such as fever or chills, muscle or joint pain, nausea, vomiting or diarrhea
• Shortness of breath or coughing
• Headache

Side effects specific to monoclonal antibodies may include:

• Needle site reactions, such as pain, itchiness or swelling
• Flu-like symptoms
• More serious rashes
• Mouth and skin sores that may become infected

More serious side effects of monoclonal antibodies may include:

• High blood pressure
• Serious heart problems, such as congestive heart failure (in which the heart has trouble pumping enough blood to meet the body’s needs) or heart attacks
• Swelling in the lungs
• Blood vessel leaks that result in very low blood pressure

Monoclonal Antibodies at City of Hope

City of Hope scientists are at the forefront of monoclonal antibody research and innovation. Our researchers developed the genetic processes for rendering monoclonal antibodies more effective in fighting cancer, which has been critical to the development of new treatments. Our scientists continue to evaluate new options and improve the efficacy of existing monoclonal antibody therapies to develop more powerful cancer treatments.

Learn more about our monoclonal antibody research