Therapeutic antibodies, shock weapons against cancer and inflammatory diseases

(AFP) – At the recent Congress Against Cancer in Chicago, they caused a stir: more than twenty years after their first commercialization, therapeutic antibodies are more promising than ever and are also attracting the interest of investors.

At the annual meeting of the American Society of Clinical Oncology (ASCO) in early June, which brings together cancer specialists worldwide, one study attracted particular attention: the presentation of a clinical study on Enhertu, an antibody developed by the Japanese pharmaceutical company Daiichi Sankyo, and the Anglo-Swedish AstraZeneca.

This treatment has already been approved for patients suffering from breast cancer with high levels of a protein called HER2. It has also been shown to be effective in patients with this protein, but at lower levels, increasing the number of patients who could benefit.

An important advance, according to Professor William Jacot from the Cancer Institute of Montpellier in southern France, who took part in this clinical study. “We hadn’t seen this kind of improvement in survival from chemotherapy treatment in decades,” he says.

“It’s an antibody + armed + with chemotherapy: the antibody sticks to the surface of the cancer cell, whose receptors no longer work. The cell + then digests + the receptors to recycle them: this is where the chemotherapy is released,” explains the oncologist .

– Nobel Prize for Medicine –
The announcements follow one another and also arouse the enthusiasm of investors: Recently, the French biotech ImCheck collected almost 100 million euros for an antibody that is currently in development. And the big labs are not left out, willing to pay dearly. In 2018, the French company Sanofi bought the Belgian biotech company Ablynx for almost 4 billion euros and thus got its hands on its nanobodies (mini antibodies).

But how do these antibodies work? In its natural state, it is an alarm signal generated by the immune system. Antibodies, which are proteins, recognize foreign substances (called antigens), attach themselves to them and signal them to the rest of the immune system.

However, in 1975 two scientists, Gerard Koehler and Cesar Milstein, discovered how to make them in the laboratory, which earned them the Nobel Prize in Medicine. Since then, dozens of synthetic antibodies have been developed.

Another advantage of the technology: although it is complex to produce, it is less complicated and more expensive to implement than the new cell therapy treatments.

In cancer, several modes of action are possible. Therapeutic antibodies, for example, target and bind to proteins necessary for cancer cell production to destroy them. Others can act on the regulation of the immune response.

– Destroy the diseased cell –
In recent years, the range has been expanded to include chemotherapy-conjugated antibodies such as Enhertu. This is also the track developed by French biotech company Inatherys, which is currently in phase 1 of a clinical trial in leukemia, explains Pierre Launay, director of the company.

“Our antibody binds to the transferrin receptor, a receptor that allows iron to enter the cancer cell. This is an interesting target because cancer cells need iron to destroy diseased cells,” he says.

In addition to cancer, these treatments are being developed for inflammatory diseases. And even against infections, such as in the treatment of patients with Covid-19: The preventively used Evusheld antibodies from AstraZeneca or the cure Xevudy from the British GSK are particularly worth mentioning.

With these many potential indications, the market is lively: Dupixent, Sanofi’s flagship drug in immunotherapy, brought in more than 5 billion euros for the laboratory last year. Keytruda, used in oncology, generated more than $17 billion for American MSD in 2021.

According to estimates by the company Market Data Forecast, the global market could reach $249 billion within three years.

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