Global Impact of Monoclonal Antibodies (mAbs) in Children: A Focus on Anti-GD2
Abstract
:Simple Summary
Abstract
1. Introduction
2. Monoclonal Antibodies and Pediatric Cancer
2.1. Monoclonal Antibodies in Pediatric Hematological Malignancies
2.2. Monoclonal Antibodies Specifically Developed for Pediatric Solid Tumors
Anti-GD2 Monoclonal Antibodies
2.3. Monoclonal Antibodies Repurposed for Pediatric Solid Tumors
3. Monoclonal Antibodies for Childhood Cancer: Current Limitations and Future Strategies
3.1. Biological Limitations
3.1.1. Paucity of Clinically Relevant Targets
3.1.2. Antigen Loss or Downregulation under Immune Pressure
3.1.3. Poor Tumor Penetration
Drug Conjugates
Radio-Immuno-Conjugates
Drug Delivery Platforms
3.1.4. Insufficient or Impaired Effector Functions
Mechanisms of Anti-GD2 Resistance | Strategies to Overcome Them |
---|---|
Antigen loss or downregulation by epigenetic modulation | EZH2 inhibition [113,114,115] |
Poor tumor penetration | Increased payload: Antibody-drug-conjugates [121] Radio-immunotherapy conjugates [122,123] Drug delivery platforms [124] |
Impaired effector functions | Fc engineering [120,137,138] Engaging T-cells by bispecific antibodies [139,140,141,142] Co-administration with certain cytokines [136] or immuno-conjugates [136,147,148] Co-administration with granulocyte-macrophage colony-stimulating factor GM-CSF [50,53,133,134] Early administration of antibody within the cytotoxic therapeutic plan [150] GD2 conjugated vaccines [152,153] |
3.1.5. Lack of Biomarkers to Predict Response and Survival
3.2. Difficult Integration into the Standards of Care
3.3. Commercialization, Regulation, and Political Limitations
4. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Correction Statement
References
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MAb | FDA Approval for Adults | FDA Approval for Children | EMA Approval for Adults | EMA Approval for Children | Median Time Gap (Years) |
---|---|---|---|---|---|
Rituximab | 1997 | 2021 | 1998 | 2020 | 23 |
Breuntuximab vedotin | 2011 | 2022 | NA | NA | 11 |
Blinatumomab | 2014 | 2018 | 2015 | 2016 | 2.5 |
Gemtuzumab ozogamycin | 2017 1 | 2017 | 2017 2 | 2017 | 0 |
Inotuzumab | 2017 | NA | 2017 | NA | NA |
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Larrosa, C.; Mora, J.; Cheung, N.-K. Global Impact of Monoclonal Antibodies (mAbs) in Children: A Focus on Anti-GD2. Cancers 2023, 15, 3729. https://doi.org/10.3390/cancers15143729
Larrosa C, Mora J, Cheung N-K. Global Impact of Monoclonal Antibodies (mAbs) in Children: A Focus on Anti-GD2. Cancers. 2023; 15(14):3729. https://doi.org/10.3390/cancers15143729
Chicago/Turabian StyleLarrosa, Cristina, Jaume Mora, and Nai-Kong Cheung. 2023. "Global Impact of Monoclonal Antibodies (mAbs) in Children: A Focus on Anti-GD2" Cancers 15, no. 14: 3729. https://doi.org/10.3390/cancers15143729