Monoclonal Antibodies

Monoclonal antibodies are immune system proteins that are created in the lab. Antibodies
are produced naturally by your body and help the immune system recognize germs that
cause disease, such as bacteria and viruses, and mark them for destruction. Like your body’s
own antibodies, monoclonal antibodies recognize specific targets.

Many monoclonal antibodies are used to treat cancer. They are a type of targeted cancer
therapy, which means they are designed to interact with specific targets.

Some monoclonal antibodies are also immunotherapy because they help turn the immune
system against cancer. For example, some monoclonal antibodies mark cancer cells so that
the immune system will better recognize and destroy them. An example is rituximab, which
binds to a protein called CD20 on B cells and some types of cancer cells, causing the immune
system to kill them. B cells are a type of white blood cell.

Other monoclonal antibodies bring T cells close to cancer cells, helping the immune cells kill
the cancer cells. An example is blinatumomab (Blincyto®), which binds to both CD19, a
protein found on the surface of leukemia cells, and CD3, a protein on the surface of T cells.
This process helps the T cells get close enough to the leukemia cells to respond to and kill
them.

What are the side effects of monoclonal antibodies?

Monoclonal antibodies can cause side effects, which can differ from person to person. The
ones you may have and how they make you feel will depend on many factors, such as how
healthy you are before treatment, your type of cancer, how advanced it is, the type of
monoclonal antibody you are receiving, and the dose.

Doctors and nurses cannot know for sure when or if side effects will occur or how serious
they will be. So, it is important to know which signs to look for and what to do if you start to
have problems.

Like most types of immunotherapy, monoclonal antibodies can cause skin reactions at the
needle site and flu-like symptoms.

Needle site reactions include:

 pain
 swelling
 soreness
 redness
 itchiness
 rash

Flu-like symptoms include:

 chills
 fatigue
 fever
 muscle aches and pains
 nausea
 vomiting
 diarrhea

Monoclonal antibodies can also cause:

 mouth and skin sores that can lead to serious infections

 high blood pressure
 congestive heart failure
 heart attacks
 inflammatory lung disease

Monoclonal antibodies can cause mild to severe allergic reactions while you are receiving
the drug. In rare cases, the reaction is severe enough to cause death.

Some monoclonal antibodies can also cause capillary leak syndrome. This syndrome causes
fluid and proteins to leak out of tiny blood vessels and flow into surrounding tissues,
resulting in dangerously low blood pressure. Capillary leak syndrome may lead to multiple
organ failure and shock.

Cytokine release syndrome can sometimes occur with monoclonal antibodies, but it is often
mild. Cytokines are immune substances that have many different functions in the body, and
a sudden increase in their levels can cause:

 fever
 nausea
 headache
 rash
 rapid heartbeat
 low blood pressure
 trouble breathing

HYBRIDIZATION
Hybridization, as related to genomics, is the process in which two complementary single-
stranded DNA and/or RNA molecules bond together to form a double-stranded molecule.
The bonding is dependent on the appropriate base-pairing across the two single-stranded
molecules. Hybridization is an important process in various research and clinical laboratory
techniques.
Hybridization. DNA is usually found as a double-stranded molecule. The two strands bind to
one another in a complementary fashion by a process called hybridization. Naturally, when
DNA is replicated, the new strand hybridizes to the old strand. In the laboratory, we can
make small pieces of DNA, designed to screen for the presence or absence of certain DNA or
RNA molecules in the cell. It also plays an important role in a procedure called polymerase
chain reaction, known as PCR, where we amplify specific regions of the gene, and this is
used in clinical testing.

IN SITU HYBRIDIZATION
In situ hybridization is a laboratory technique used to localize a sequence of DNA or RNA in a
biological sample. In this technique, a biological sample consisting of tissue sections, cells or
chromosomes from an individual is affixed to a glass slide and then exposed to a “probe”—a
small piece of single-stranded DNA tagged with a chemical or fluorescent dye. The labeled
probe finds and then binds to its matching sequence within the biological sample. The
location of the bound probe can then be seen with the use of a microscope.

FLUORESCENCE IN SITU HYBRIDIZATION (FISH)

Fluorescence in situ hybridization (abbreviated FISH) is a laboratory technique used to
detect and locate a specific DNA sequence on a chromosome. In this technique, the full set
of chromosomes from an individual is affixed to a glass slide and then exposed to a
“probe”—a small piece of purified DNA tagged with a fluorescent dye. The fluorescently
labeled probe finds and then binds to its matching sequence within the set of
chromosomes. With the use of a special microscope, the chromosome and sub-
chromosomal location where the fluorescent probe bound can be seen.