mAbs

By Terri Bentler, BSN, RN, OCN, CN-BN May 11, 2017

I am a lover of words. Oncology drugs provide me great fodder for learning new, unique names. It’s not an easy task. Medications — with new names — are always in the pipeline. Confusing matters, many medications have a generic and a brand name. The double names can be a challenge to remember, alongside all the challenges a cancer diagnosis introduces to your life.

For this discussion, I will concentrate on the “mAbs.”
Monoclonal antibodies — “mAbs” — are targeted therapies. They are used to treat a variety of types of cancer, as well as multiple sclerosis, rheumatoid arthritis and osteopenia. They work with the body’s immune system by disguising themselves as antibodies and triggering the body’s defense system to attack particular cells. They identify specific targets, breaking down cell walls, stopping cell growth, blocking blood supply to cells, paving the way for cancer-cell fighters, causing cells to self-destruct and as a vehicle to deliver radiation.

Cells have proteins called antigens on their surface. Antibodies search out and stick to certain antigens to start the body’s immune response. Their goal is to destroy the affected cells before they can divide and increase their numbers. Researchers have created lab copies — clones — of certain antibodies to treat cancer, hence the name ‘monoclonal antibodies.’

Monoclonal antibodies are developed in various forms: naked, conjugated and bispecific.

  • Naked monoclonal antibodies work alone and are the most common medication in use. Alemtuzumab (Campath) and Trastuzumab (Herceptin), Bevacizumab (Avastin), Cetuximab (Erbitux) and Rituximab (Rituxan) are some of the naked drugs.
  • Conjugated monoclonal antibodies are paired with chemotherapy or a radioactive compound to get right to the cancer cells. Examples of drugs pairing with chemotherapy are Brentuximab (Adcetris) and Ado-trastuzumab (Kadcyla). Irbritumumab (Zevalin) is a pairing with radioactive particles.
  • Bispecific monoclonal antibodies combine two different mAbs to target two different proteins at the same time. Bilnatumomab (Blincyto) is a bispecific drug.

There are at least 28 mAbs in use to treat cancer and other illness.
General side effects of these drugs are similar to having the flu. You may experience chills, fever, rash, headache and an overall unwell feeling. Specific drugs in this category may also cause skin effects similar to acne. It is important to discuss the side effects of your specific drug with your care team.

And below, a little fun I had with words.
What joy, to my tongue, is the world of mAbs.
The multiple syllables forming complex speech.
Tongue curling, rolling, knocking against teeth.
My ears delight to hear the results.
Alemtuzumab bought a new Secuninumab to Golimumab.
In style. Showing all the Basiliximabs just how Ipilimumab and Infliximab.
Living benefits all who partake. Omalizumab and Natalizumab disagreed with the approach.
But Usetkinumab rejoiced over the beauty with Belimumab.
And the grand Panitumumab declared, “All is well.”

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