Development of monoclonal antibodies to target the virus has been
endorsed by leading scientists. Anthony Fauci, the top U.S.
infectious diseases expert, called them "almost a sure bet" against
COVID-19.
When a virus gets past the body's initial defenses, a more specific
response kicks in, triggering production of cells that target the
invader. These include antibodies that recognize and lock onto a
virus, preventing the infection from spreading.
Monoclonal antibodies - grown in bioreactor vats - are copies of
these naturally-occurring proteins.
Scientists are still working out the exact role of neutralizing
antibodies in recovery from COVID-19, but drugmakers are confident
that the right antibodies or a combination can alter the course of
the disease that has claimed more than 675,000 lives globally.
"Antibodies can block infectivity. That is a fact," Regeneron
Pharmaceuticals executive Christos Kyratsous told Reuters.
Regeneron is testing a two-antibody cocktail, which it believes
limits the ability of the virus' to escape better than one, with
data on its efficacy expected by late summer or early fall.
"Protection will wane over time. Dosing is something we don't know
yet," said Kyratsous.
The U.S. government in June awarded Regeneron a $450 million supply
contract. The company said it can immediately begin production at
its U.S. plant if regulators approve the treatment.
Eli Lilly and Co <LLY.N, AstraZeneca, Amgen, and GlaxoSmithKline
were cleared by the U.S. government to pool manufacturing resources
in order to scale up supplies if any of these drugs prove
successful.
Even with that unusual cooperation among rivals, manufacturing these
medicines is complex and capacity is limited. There is also a debate
over whether a single antibody will be powerful enough to stop
COVID-19.
AstraZeneca said it plans to start human trials of its dual-antibody
combination within weeks.
Lilly, which began human testing in June of two antibody candidates
in separate trials, is focusing on a one-drug approach.
"If you need a higher dosage or more antibodies, fewer people can be
treated," Lilly Chief Scientific Officer Dan Skovronsky said.
'INSTANT IMMUNITY'
Unlike vaccines, which activate the body's own immune system, the
impact of infused antibodies eventually dissipates.
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Still, drugmakers say monoclonal antibodies could temporarily prevent infection
in at-risk people such as medical workers and the elderly. They could also be
used as a therapeutic bridge until vaccines become widely available.
"In a prophylactic setting we think we may achieve coverage for up to six
months," said Phil Pang, chief medical officer of Vir Biotechnology, which aims
to start testing an antibody in non-hospitalized patients next month with
partner GSK.
"The advantage of an antibody is that it is basically instant immunity," said
Mark Brunswick, senior vice president at Sorrento Therapeutics, which aims to
begin human trials next month of a single antibody candidate.
Safety risks for monoclonal antibodies are considered low, but their cost can be
quite high. These type of drugs for cancer can cost over $100,000 a year.
There is also concern that the coronavirus could become resistant to specific
antibodies. Researchers are already at work on second-generation compounds with
targets other than the crown-like spikes the virus uses to invade cells.
"We are trying to develop something that is complementary," Amgen research chief
David Reese said. Amgen is working with Adaptive Biotechnologies Corp.
Researchers in a recent paper published in the journal Nature said they had
discovered several new, very potent, antibodies directed to an area where the
virus attaches to human cells and to a region of the spike that has not
attracted attention.
"To avoid development of resistance you want to target different sites," study
author and Columbia University professor David Ho told Reuters.
There are also questions about when in the course of the illness it might be
best to employ these new weapons.
"Giving an antibody later on after infection might not be that helpful, said
Florian Krammer, microbiology professor at New York's Icahn School of Medicine.
"Given early, they probably work well."
(Reporting By Deena Beasley, editing by Peter Henderson and Bill Berkrot)
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