Isotype selection for antibody-based cancer therapy

Clin Exp Immunol. 2021 Mar;203(3):351-365. doi: 10.1111/cei.13545. Epub 2020 Nov 30.

Abstract

The clinical application of monoclonal antibodies (mAbs) has revolutionized the field of cancer therapy, as it has enabled the successful treatment of previously untreatable types of cancer. Different mechanisms play a role in the anti-tumour effect of mAbs. These include blocking of tumour-specific growth factor receptors or of immune modulatory molecules as well as complement and cell-mediated tumour cell lysis. Thus, for many mAbs, Fc-mediated effector functions critically contribute to the efficacy of treatment. As immunoglobulin (Ig) isotypes differ in their ability to bind to Fc receptors on immune cells as well as in their ability to activate complement, they differ in the immune responses they activate. Therefore, the choice of antibody isotype for therapeutic mAbs is dictated by its intended mechanism of action. Considering that clinical efficacy of many mAbs is currently achieved only in subsets of patients, optimal isotype selection and Fc optimization during antibody development may represent an important step towards improved patient outcome. Here, we discuss the current knowledge of the therapeutic effector functions of different isotypes and Fc-engineering strategies to improve mAbs application.

Keywords: Fc tail; cancer; effector functions; isotype; mAbs.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antibodies, Monoclonal / immunology
  • Antibodies, Monoclonal / therapeutic use*
  • Cytotoxicity, Immunologic / drug effects*
  • Cytotoxicity, Immunologic / immunology
  • Humans
  • Immunoglobulin A / immunology
  • Immunoglobulin A / therapeutic use
  • Immunoglobulin D / immunology
  • Immunoglobulin D / therapeutic use
  • Immunoglobulin E / immunology
  • Immunoglobulin E / therapeutic use
  • Immunoglobulin G / immunology
  • Immunoglobulin G / therapeutic use
  • Immunoglobulin Isotypes / classification
  • Immunoglobulin Isotypes / immunology
  • Immunoglobulin Isotypes / therapeutic use*
  • Immunoglobulin M / immunology
  • Immunoglobulin M / therapeutic use
  • Neoplasms / drug therapy*
  • Neoplasms / immunology

Substances

  • Antibodies, Monoclonal
  • Immunoglobulin A
  • Immunoglobulin D
  • Immunoglobulin G
  • Immunoglobulin Isotypes
  • Immunoglobulin M
  • Immunoglobulin E