Potential therapeutic roles for antibody mixtures

With the enormous success of recombinant monoclonal antibodies (rMAbs) as human therapeutics, there are increasing efforts underway to explore new molecular entities that mimic rMAbs to replicate this huge success. In addition to naked intact rMAbs, antibody drug conjugates (ADCs), FAb and F(ab')2 fragments and also Fc fusion proteins have been developed and/or marketed as human therapeutics to treat different human diseases, including life-threatening diseases such as cancer. Several hundreds more intact rMAbs, ADCs, FAb, F(ab')2 fragments and Fc fusion proteins are currently undergoing human clinical trials. In addition to these molecules, new type of antibody fragments such as single-chain Fvs (scFvs), V-H, scFv-Fc, scFv-C-H, scFAb, scFv-zipper, diabodies, bispecific antibodies and similar types of constructs are also being investigated to be developed as human monotherapeutics. Further, there are quite a few current examples of combinations of biologics being developed. For example, currently, several biopharmaceutical companies are developing combinations of antibody mixtures as human therapeutics. Accordingly, the question posed here is whether it is time to consider the possibility of developing a broader range of combinations of therapeutic biologics. Combinations of small organic molecules have been successfully used as therapeutics for many years to treat many diseases, so the context of using polypharmacology to treat human diseases is not novel. For the past several decades, intravenous immunoglobulins have successfully been used in treating various autoimmune diseases. In this context, several biotechnology companies are exploring the use of combinations of antibody mixtures as human therapeutics. This editorial discusses these current efforts and the potential future role of antibody mixtures as human therapeutics.