Expert opinions on endocrine toxicity induced by new anticancer therapies: Precautions to be taken in performing and interpreting hormonal assays under immunotherapy |
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| Institution: | 1. Institute of Pediatrics, Guangzhou Women and Children''s Medical Center, Guangzhou Medical University, Guangzhou, China;2. The Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children''s Medical Center, Guangzhou Medical University, Guangzhou, China;1. Royal Brompton & Harefield NHS Foundation Trust, London, UK;2. Critical Diagnostics, San Diego, CA, United States of America;3. Department of Medicine, Stony Brook University, Stony Brook, NY, United States of America;4. Department of Medicine, Emory University, Atlanta, GA, United States of America;5. Department of Medicine, University of Mississippi, Jackson, MS, United States of America |
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| Abstract: | As well as tyrosine kinase and mTOR inhibitors, new anticancer therapies make use of antibodies targeting tyrosine kinase receptors or blocking anti-tumor immune response checkpoints. These are always monoclonal; in their international non-proprietary names, the origin is prefixed to “-mab”: e.g., mouse antibodies end in “o-mab”, chimeric antibodies in “xi-mab”, humanized antibodies in “zu-mab” and human antibodies in “u-mab”. When the analytic principle of the assay involves a murine monoclonal antibody and the therapeutic antibody contains a murine sequence, analytic interference is to be feared if the patient develops antibodies against the therapeutic antibody. The interfering heterophilic antibody may be a HAMA (anti-mouse), a HACA (anti-chimeric) or a HAHA (anti-humanized-antibody). In immunoassay for patients under immunotherapy, it is therefore recommended to check the type of therapeutic antibody: if it is liable to contain murine sequences, heterophilic antibodies should be screened for and neutralized. |
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