What are these monoclonal antibodies? Let's understand it simply.

You may have heard that there are new, advanced treatments for serious diseases like cancer. Sometimes the doctor may say, "There is a special medicine for this that uses our own immune system." Today, we are going to talk about a treatment that has made a big breakthrough in medicine. These are called monoclonal antibodies. Although the name is a bit complicated, the story is very simple. Let's see what this is.

What are these monoclonal antibodies?

Simply put, these are special proteins made in a lab that work in the same way as the antibodies that our bodies produce naturally.

Now think about it, our body is like a country. There is an army to protect this country. That army is our immune system . Germs and disease-causing substances (we call these antigens ) that come from outside are like enemies coming to our country. These antibodies are the special soldiers in our army. Their job is to find, capture, and destroy these enemies.

Sometimes, even though things like cancer cells grow in our own bodies, our immune system can't recognize them. That's when we seek outside help.

Monoclonal Antibodies are, to put it simply, like specially trained, super-smart, cloned soldiers created in a lab. "Mono" means "one." "Clonal" means "copy." That is, a single super-smart antibody is selected and millions of exact copies of it are made in the lab. This army of antibodies is then injected into our bodies as a medicine. They go straight to the cells that are causing the disease (e.g., cancer cells), attach to them, and help our own immune system destroy them.

What is the difference between monoclonal and polyclonal?

This is also very simple.

• Monoclonal: This is like a sniper. There is only one target. These antibodies are designed to attach to only one antigen . Therefore, they are very specific and will not miss the target.
• Polyclonal: "Poly" means "many." These are a collection of different antibodies. Like an army with different weapons, they can attack several types of antigens .

Monoclonal antibodies are most commonly used for treatment because they are targeted specifically.

What are these used for?

This treatment method is now used for many things. From research to curing diseases.

What diseases are treated with monoclonal antibodies?

This treatment method is now being used successfully for a number of diseases. Some of them include:

• Cancer: For various types of cancer such as breast cancer, colon cancer, and blood cancer.
• To prevent organ transplant rejection: Stop the body from rejecting a transplanted organ (such as a kidney, liver).
• Autoimmune disorders: For diseases in which the body's immune system attacks its own cells, such as rheumatoid arthritis and Crohn's disease.
• Allergies: For severe asthma and other allergies.
• Infections: They have also been used to treat some viral infections, such as COVID-19.
• Osteoporosis
• Eye conditions
• Migraines
• High cholesterol

How is the treatment given?

This treatment is often given as a saline-like liquid into a vein (intravenous or IV infusion). This is usually given in a special unit (infusion center) in a hospital or clinic. Several other people may be receiving treatment there at the same time as you are being treated.

If this is your first time having this treatment, your doctor may ask you to bring a family member with you so that they can learn about the treatment and what to expect afterward. During the first treatment, the medical staff will watch you carefully to see if you have any serious allergic reactions .

Very rarely, some monoclonal antibodies are also given as a subcutaneous injection. If this is the case, you will be taught how to give yourself the vaccine.

Are there different types of this treatment?

Yes, these "cloned" soldiers can perform a variety of operations. Accordingly, there are three main types.

What are the advantages of this treatment method?

• Targeted therapy: This is the biggest advantage. Unlike regular chemotherapy, this treatment causes very little damage to healthy cells. Because it attacks only the target, there are fewer side effects.
• High success rate: This treatment method has yielded very successful results for diseases such as some types of cancer.
• Quality: Because it is made in a laboratory, every batch of medicine produced is of the same standard.
• Mass production: These can now be produced in large quantities.

Are there any risks or complications with this treatment?

As with any treatment, there are some risks involved. But don't worry, your doctor will explain everything to you.

Common complications include:

• Infusion reactions: These can occur during or shortly after the drug is given into a vein. These are usually not serious.
• Skin rash
• Fever
• Shivering due to cold
• Difficulty breathing
• Sweating
• Blood pressure changes
• Increased heart rate

If something like this happens, it can be controlled by slowing down the rate of drug administration or stopping it for a while.

• More severe (but rarely seen) reactions:
• Acute Anaphylaxis: This is a severe allergic reaction that occurs suddenly and can be life-threatening. This is why careful monitoring is required when first administering the treatment.
• Cytokine Release Syndrome (CRS): This is a condition where the immune system becomes overactive and causes a "storm." This can damage organs.
• Serum sickness: This is when our body starts attacking the very protein (antibody) that was given as treatment.

Some risks may be specific to the disease being treated. For example, cancer treatment can cause a condition called tumor lysis syndrome , which is when cancer cells are destroyed so rapidly that the kidneys can no longer handle the waste products they produce.

How long does it take to recover after treatment?

The time it takes for the drug to be given intravenously can vary. For example, in some treatments for COVID-19, the drug was given for about an hour, followed by about an hour of observation.

That's why you should come with a family member on the first day. If there are no side effects, you can come alone for the next treatments. If you are not tired after the treatment, ask your doctor if you can continue with your normal activities (work, school). It depends on your condition and overall health.

Should I talk to the doctor about this?

Definitely yes.

• If you are already receiving monoclonal antibody treatment and you experience any unusual symptoms (like the reactions we discussed earlier), call your doctor immediately or go to the Emergency Department (ETU).

• If you have a condition that has been identified as a potential treatment option, talk to your doctor about whether this monoclonal antibody treatment is right for you. He or she will evaluate your condition, explain the pros and cons, and explain whether it is right for you.

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