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Monoclonal antibody drugs for cancer treatment: How they work
How are monoclonal antibody drugs used in cancer treatment?
Monoclonal antibodies are administered through a vein (intravenously). How often you undergo monoclonal antibody treatment depends on your cancer and what drug you're receiving. Some monoclonal antibody drugs may be used in combination with other treatments, such as chemotherapy and hormone therapy. Others are administered alone.
Monoclonal antibody drugs were initially used to treat advanced cancers that hadn't responded to chemotherapy or cancers that had returned despite treatment. However, because these treatments have proved to be effective, certain monoclonal antibody treatments are being used earlier in the course of the disease. For instance, rituximab can be used as an initial treatment in some types of non-Hodgkin's lymphoma, and trastuzumab (Herceptin) is used in the treatment of some forms of early breast cancer.
Many of the monoclonal antibody therapies are still considered experimental. For this reason, these treatments are usually reserved for advanced cancers that aren't responding to standard, proven treatments.
| FDA-approved monoclonal antibodies for cancer treatment | |
|---|---|
| Name of drug | Type of cancer it treats |
| Alemtuzumab (Campath) | Chronic lymphocytic leukemia |
| Bevacizumab (Avastin) | Brain cancer Colon cancer Kidney cancer Lung cancer |
| Cetuximab (Erbitux) | Colon cancer Head and neck cancers |
| Ibritumomab (Zevalin) | Non-Hodgkin's lymphoma |
| Ofatumumab (Arzerra) | Chronic lymphocytic leukemia |
| Panitumumab (Vectibix) | Colon cancer |
| Rituximab (Rituxan) | Chronic lymphocytic leukemia Non-Hodgkin's lymphoma |
| Tositumomab (Bexxar) | Non-Hodgkin's lymphoma |
| Trastuzumab (Herceptin) | Breast cancer Stomach cancer |
Source: Food and Drug Administration (FDA), Center for Drug Evaluation and Research
What types of side effects do monoclonal antibody drugs cause?
In general, monoclonal antibody treatment carries fewer side effects than do traditional chemotherapy treatments. However, monoclonal antibody treatment for cancer may cause side effects, some of which, though rare, can be very serious. Talk to your doctor about what side effects are associated with the particular drug you're receiving.
Common side effects
In general, the more-common side effects caused by monoclonal antibody drugs include:
- Allergic reactions, such as hives or itching
- Flu-like signs and symptoms, including chills, fatigue, fever, and muscle aches and pains
- Nausea
- Diarrhea
- Skin rashes
Serious side effects
Serious, but rare, side effects of monoclonal antibody therapy may include:
- Infusion reactions. Severe allergy-like reactions can occur and, in very few cases, lead to death. You may receive medicine to block an allergic reaction before you begin monoclonal antibody treatment. Infusion reactions usually occur while treatment is being administered or soon after, so your health care team will watch you closely for a reaction.
- Dangerously low blood cell counts. Low levels of red blood cells, white blood cells and platelets may lead to serious complications.
- Heart problems. Certain monoclonal antibodies may cause heart problems, including heart failure and a small risk of heart attack.
- Skin problems. Sores and rashes on your skin can lead to serious infections in some cases. Serious sores can also occur on the tissue that lines your cheeks and gums (mucosa).
- Bleeding. Some of the monoclonal antibody drugs are designed to stop cancer from forming new blood vessels. There have been reports that these medications can cause bleeding.
What should you consider when deciding on monoclonal antibody drug treatment?
Discuss your cancer treatment options with your doctor. Together you can weigh the benefits and risks of each treatment and decide whether a monoclonal antibody treatment is right for you.
Questions to ask your doctor include:
- Has the monoclonal antibody drug shown a clear benefit? Some monoclonal antibody drugs are approved for advanced cancer, though they haven't been shown to extend lives. Instead, some drugs are more likely to slow a cancer's growth or stop tumor growth temporarily.
- What are the likely side effects of monoclonal antibody treatment? With your doctor, you can determine whether the potential side effects of treatment are worth the likely benefit.
- How much will monoclonal antibody treatment cost? Monoclonal antibody drugs can cost thousands of dollars per treatment. Insurance doesn't always cover these costs.
- Is monoclonal antibody treatment available in a clinical trial? Clinical trials, which are studies of new treatments and new ways to use existing treatments, may be available to you. In a clinical trial, the cost of the monoclonal antibody drug may be paid for as a part of the study. Also, you may be able to try new monoclonal antibody drugs. Talk to your doctor about what clinical trials may be open to you.
(2 of 2)
- Cheung NV. Therapeutic antibodies and immunologic conjugates. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2008:531.
- Monoclonal antibodies. American Cancer Society. http://www.cancer.org/Treatment/TreatmentsandSideEffects/TreatmentTypes/Immunotherapy/immunotherapy-monoclonal-antibodies. Accessed Nov. 17, 2010.
- Found 2042 studies with search of: monoclonal antibody AND cancer. ClinicalTrials.gov. http://clinicaltrials.gov/ct2/results?term=monoclonal+antibody+AND+cancer. Accessed Nov. 18, 2010.
- Campath (prescribing information). Wayne, N.J.: Genzyme Corp.; 2007. http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/103948s5070lbl.pdf. Accessed Nov. 17, 2010.
- Bexxar (prescribing information). Seattle, Wash.: Corixa Corp.; 2004. http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/125011_0024lbl.pdf. Accessed Nov. 17, 2010.
- Avastin (prescribing information). South San Francisco, Calif.: Genentech, Inc.; 2009. http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/125085s0168lbl.pdf. Accessed Nov. 17, 2010.
- Herceptin (prescribing information). South San Francisco, Calif.: Genentech, Inc.; 2010. http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/103792s5256lbl.pdf. Accessed Nov. 17, 2010.
- Erbitux (prescribing information). Branchburg, N.J.: ImClone Systems Inc.; 2009. http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/125084s167lbl.pdf. Accessed Nov. 17, 2010.
- Arzerra (prescribing information). Research Triangle Park, N.C.: GlaxoSmithKline; 2009. http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/125326lbl.pdf. Accessed Nov. 17, 2010.
- Vectibix (prescribing information). Thousand Oaks, Calif.: Amgen Inc.; 2009. http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/125147s080lbl.pdf. Accessed Nov. 17, 2010.
- Zevalin (prescribing information). Cambridge, Mass.: Biogen Idec Inc.; 2009. http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/125019s0156.pdf. Accessed Nov. 17, 2010.
- Rituxan (prescribing information). South San Francisco, Calif.: Genentech, Inc.; 2010. http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/103705s5311lbl.pdf. Accessed Nov. 17, 2010.
- FDA commissioner removes breast cancer indication from Avastin label. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/ucm279485.htm. Accessed Nov. 18, 2011.
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