TECH OUTLOOK 8JULY - 2021IN MY OPINIONAntibodies: The Building Blocks of CuresBy John Armstrong, Head of Research; Head of BD; Global Strategic Programs; Global Straegic Marketing, GaldermaWhat's your sign?Personalized therapy for cancer is generally based on the identification of a single, molecular biomarker expressed by a patient's tumor. On the other hand, personalizing therapy for immune-mediated inflammatory disorders (IMIDs) is not so straightforward and requires a complex, translational medicine approach. IMIDs include diseases such as rheumatoid arthritis, psoriasis, Crohn's Disease, asthma, and others. How these inflammatory diseases are driven (and hence, can be controlled) can differ from patient to patient. While genomics and proteomics play a role, we gain insight into each patient's inflammatory drivers primarily by looking at patterns of mRNA expression from blood, biopsies, tape strips, and other sampling technologies. In 1970, we were asked "What's your sign", and our answers were `Aquarius', `Gemini', `Virgo' and the like. Half a century later, those of us still around but now in translational medicine don't want your astrological sign but your transcriptional signature. With this information our chances are better that you can be prescribed the most appropriate antibody-based therapy for your IMID, whether that's a disease of the skin, the joints, the gut, the lungs, or the nervous system.Why mAbs?Monoclonal antibodies (mAbs) have become the therapy of choice for severe IMIDs for a number of reasons, not the least of which is their exquisite specificity. Generally speaking, small molecular entity (SME)-based therapies also can be very specific, but for the treatment of an IMID, they aren't often capable of targeting a single, terminal effector cytokine, such as IL-17 for psoriasis. Instead, they are often used for targetingintracellular, inflammatory pathway intermediates, such as JAK kinases. When administered orally, as one would do for a severe IMID, they can bring unwanted, off-target downstream effects more often than when relying on mAbs. Antibody Discovery and EngineeringBecause mAb technology evolves so rapidly, it can be challenging for any established Biopharma company to have the latest tools at its disposal, and outsourcing is the answer to
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