Apomab: An agonist monoclonal antibody directed against Death Receptor 5/TRAIL-Receptor 2 for use in the treatment of solid tumors

Background: Apomab is a pro-apoptotic anticancer agonist monoclonal antibody against Death receptor 5 (DR5)/TNF-related apoptosis inducing ligand-receptor 2 (TRAIL-R2). Objective: To review available preclinical and clinical data and compare Apomab with similar agents. Methods: Manuscripts were identified (PubMed) using the terms TRAIL-R2, DR5 and Apomab. Abstracts from major oncology meetings in 2005 - 2008 were hand-searched. Results/conclusion: Apomab demonstrates preclinical activity against a range of solid tumors, both as monotherapy and in combination with cytotoxics. Clinical data are limited but Apomab exposures appear compatible with intermittent dosing alongside standard chemotherapy regimens. Transaminitis has been noted in 1 out of 37 patients but the true frequency and severity of this and other toxicities cannot yet be determined. Apomab has shown early signs of anticancer activity in heavily pretreated patients. Several similar agents are at similar stages of development. No direct comparisons have yet been undertaken but potential differences between these agents are discussed.