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MABs Stability – Analytical Techniques


Andrew G Watts PhD.
Medicinal Chemistry Group
Department of Pharmacy and Pharmacology




                                          September 2012
Disclosure

  Glythera Ltd.

    Founder and Scientific Advisor




  Bath ASU

    Scientific Consultant
Key questions which need to be answered

    Which analytical techniques do we need to use to effectively
    evaluate the stability of MABs ?



    What do we need to consider when interpreting the results from
    these techniques?



    What amount/type of degradation is significant/important?
         - Acceptance criteria
Source Guidance

•    International Conference for Harmonization (ICH)

      •  Harmonization of British, US, Japanese and European Pharmacopeia's

      •  ICH Q2 R1 Analytical validation

      •  ICH Q5C Stability Testing of Biotechnological/Biological products

      •  ICH Q6B Specifications Test Proceedures and Acceptance criteria for
         bioltechnological/biological products


Guidelines generally aimed at the licensing of new drug products.

                                            	
  
Scope of Q5C
Q5c	
  -­‐	
  characterised	
  proteins	
  and	
  polypeptides	
  
their	
  derivatives	
  and	
  products	
  of	
  which	
  they	
  are	
  components	
  and	
  which	
  are	
  
isolated	
  from	
  tissues,	
  body	
  fluids,	
  cell	
  cultures,	
  or	
  produced	
  using	
  rDNA	
  
technology	
  
   Ø    cytokines	
  (interferons,	
  interleukins,	
  colony-­‐stimulating	
  factors,	
  tumour	
  necrosis	
  
         factors)	
  
   Ø    erythropoietins	
  
   Ø    plasminogen	
  activators	
  
   Ø    blood	
  plasma	
  factors	
  
   Ø    growth	
  hormones	
  and	
  growth	
  factors	
  
   Ø    insulins	
  
   Ø    monoclonal	
  antibodies	
  
   Ø    vaccines	
  consisting	
  of	
  well-­‐characterised	
  proteins	
  or	
  polypeptides	
  
ICH Q5C :

DOES NOT :         Provide us with a ‘recipe’ for how to analyse or interpret
                   MAB stability



DOES :             Outline criteria for a sound approach to designing protocols
                   for determining stability.

•    Primary data to support a requested storage period, long-term, real-time
     and real-condition stability studies

•    Preferable NOT to use accelerated/stressed stability testing
Stability-Indicating profile

 §  no single stability-indicating assay or parameter – profiles the stability
     characteristics of a biotechnological/biological product

 §  the stability-indicating profile should provide assurance that changes in
     the :
                                                             Primary structure
            Identity
                                       Chemical              Secondary structure
            Purity                     analysis              Tertiary structure
                                                             Quaternary structure
                                    Biological
          Potency                                             Cellular response
                                    activity
          Other characteristics

 §  the determination of which tests should be included will be product-
     specific
Degradation Pathways

                                      Impact upon:
 Physical
    •  Denaturation                       Primary structure
    •  Aggregation
    •  Surface adsorption                 Secondary structure

 Chemical                                 Tertiary structure
    •  Disulfide formation/exchange
    •  Non-reducible cross linking        Quaternary structure
    •  Deamidation
    •  Isomerization                      Cellular response
    •  Oxidation
    •  Glycosylation
Analytical   Principle         Information/use                       Advantages/ Disadvantages
method
SEC          Size              Quantify mAb and relative purity      + separation of main isoforms
                                                                     - Limited mass resolution
SDS-PAGE     Size              Estimate purity and molecular mass    + Cheap, fast
                                                                     - Limited information
                                                                     - Limited mass resolution
DLS          Size              Polydispersity, size distribution,    + Highly sensitive technique
                               detection of high molecular weight    - High polydispersity will affect accuracy
                               aggregates                            - Cannot resolve short oligomers
CD           Shape / 3D        Estimate ratios of secondary          + speed and ease of use
             structure         structures, detect changes in         + spectra can be obtained with small volume
                               tertiary structure/ conformation      and concentration of antibody
                                                                     -  Expensive instrument
                                                                     -  Diluents and excipients may show significant
                                                                        absorption in far-UV
Microflow    Size +            Count and characterisation of         + characterisation allows removal of air and oil
             morphology        aggregates                            droplets
                                                                     - Reliable shape information above 4µm
                                                                     diameter
pH           Hydrogen          Hydrogen potential of solution        + indicative of degradation processes
             potential                                               - Limited information
LC-MS        Polarity + mass   Charge to mass ratio, separation,     +Online desalting and fragment separation
                               characterisation, quantification of   + highly detailed information
                               mAb isoforms                          -  Significant method optimization
                                                                     -  Expensive and requires trained analyst
Aggregation



	
  0µm	
     	
  	
          	
  	
     	
  	
     	
  	
     	
  0.5µm	
     	
  10µm	
     	
  25µm	
     	
  50µm	
              	
  500µm	
  
                         partial unfolding                                                                             aggregation




          Wide dynamic range of aggregate types and sizes means that
          multiple techniques are need to assess this form of degradation.
SEC HPLC (Size-Exclusion)
                  Monomer
                                                   Validation (ICH Q2)

                                                   Selectivity
                                                         •  Forced degradation studies
                            Fragments
                                                   Linearity
     Aggregates                                          •  Calibration Curves
                                                         •  Limit of detection
                                                         •  Limit of quantification
                                                   Accuracy
                                                         •  Over 3 concentrations levels (min 9
                                                             injections)
                                                   Precision
                                                         •  Repeatability of 6 injections (%RSD <2%)
Higher MW                               Lower MW   Robustness
SEC HPLC (Size-Exclusion)
     Day	
     HMW-4-%           HMW-3-%           HMW-2-%           HMW-1-%           Monomer-%
                     	
                	
                	
                	
                 	
  

      A	
      0.00 ± 0.00	
     0.00 ± 0.00	
     0.00 ± 0.00	
     1.76 ± 0.24	
     98.25 ± 0.24	
  
      B	
      0.00 ± 0.00	
     0.00 ± 0.00	
     0.21 ± 0.02	
     2.18 ± 0.10	
     97.61 ± 0.12	
  
      C	
      0.00 ± 0.00	
     0.00 ± 0.00	
     0.25 ± 0.02	
     2.40 ± 0.06	
     97.36 ± 0.09	
  
      D	
      0.00 ± 0.00	
     0.00 ± 0.00	
     0.18 ± 0.11	
     2.14 ± 0.41	
     97.68 ± 0.52	
  
      E	
      0.00 ± 0.00	
     0.00 ± 0.00	
     0.21 ± 0.01	
     2.25 ± 0.03	
     97.51 ± 0.05	
  
       F	
     0.00 ± 0.00	
     0.00 ± 0.00	
     0.19 ± 0.01	
     2.27 ± 0.02	
     97.54 ± 0.02	
  
      G	
      0.00 ± 0.00	
     0.00 ± 0.00	
     0.23 ± 0.01	
     2.34 ± 0.06	
     97.44 ± 0.07	
  
      H	
      0.00 ± 0.00	
     0.00 ± 0.00	
     0.22 ± 0.01	
     2.30 ± 0.03	
     97.48 ± 0.04	
  
       I	
     0.18 ± 0.36	
     0.17 ± 0.01	
     0.82 ± 0.04	
     1.39 ± 0.08	
     97.46 ± 0.34	
  
       J	
     0.00 ± 0.00	
     0.21 ± 0.01	
     1.00 ± 0.04	
     1.54 ± 0.07	
     97.25 ± 0.08	
  



  Linearity of response and LOD, LOQ
  are crucial.

  Low molecular weight aggregates
  can be reversible
           - constant temperature
Dynamic Light Scattering (DLS)
•  Sample is illuminated with a laser
•  Measures time dependant fluctuations in the
   intensity of scattered light
•  Fluctuations occur because particles are
   constantly undergoing Brownian motion
•  Effectively measures velocity of molecules
   which can be converted on to an equivalent
   hydrodynamic radius.

The size distribution obtained is a plot of the
relative intensity of light scattered by particles in              monomer                                        aggregate
various size classes.
                            	
                                             Oligomeric     High MW        Oligomeric     High MW
                                       Z-Ave                                Species      Aggregates       Species      Aggregates
                                       (r.nm)	
     PdI	
      %PD	
       mean r.nm	
   mean r.nm	
     (%Volume)	
   (% Volume)	
  
                           Day A	
      7.98	
      0.07	
     27.33	
        8.67	
        0.00	
         100.00	
       0.00	
  
                           Day D	
      8.27	
      0.10	
     31.56	
        8.75	
      2584.67	
        100.00	
       0.00	
  
                           Day C	
      8.03	
      0.07	
     25.84	
        8.69	
        0.00	
         100.00	
       0.00	
  
                           Day D	
      8.05	
      0.08	
     28.27	
        8.79	
        0.00	
         100.00	
       0.00	
  
                           Day E	
      7.99	
      0.05	
     23.15	
        8.53	
        0.00	
         100.00	
       0.00	
  
                           Day F	
      8.02	
      0.07	
     26.12	
        8.67	
        0.00	
         100.00	
       0.00	
  
                           Day G	
      8.87	
      0.17	
     41.58	
        9.63	
      2323.33	
         99.98	
       0.02	
  
                           Day H	
      7.97	
      0.05	
     22.53	
        8.50	
        0.00	
         100.00	
       0.00	
  
                           Day I	
      7.95	
      0.05	
     21.93	
        8.49	
        0.00	
         100.00	
       0.00	
  
                           Day J	
      8.09	
      0.08	
     27.97	
        8.79	
        0.00	
         100.00	
       0.00	
  
Microflow Imaging (Particle counting)



                                                                                                           aggregated protein




                                                                                                              silicone oil

MFI uses high resolution camera to detect insoluble particles in a flow cell

•  Captures numerous frames per second
•  Software crops particles from each raw image and produces collage
•  Results must be corrected using statistical filters to distinguish silicone oil droplets and micro
   air bubbles                                                                                             micro-air bubble
                                 	
                         Particles (1000/ml) ± SD	
  
                              X mg/ml	
      > 1µm	
           >2µm	
        >10µm	
        >25µm	
  
                               Day A	
      275 ± 102	
       45 ± 29	
       5 ± 3	
      0.0 ± 0.1	
  
                               Day B	
      441 ± 14	
        194 ± 10	
     10 ± 2	
      0.0 ± 0.2	
  
                               Day C	
      166 ± 21	
        56 ± 14	
      0.3 ± 3	
     0.0 ± 0.4	
  
SDS – Page (Elecrophoresis)
                                                     Native

                                                     Tris Acetate 3-8% polyacrilamide gel

                                                     Better separation of high molecular
                                                     weight proteins (300-100kDa)

                                                     Coomassie Staining
                                                     Maximum loading of 0.5ug protein



                                                     Reducing

                                                     Bis-Tris 10% polyacrilamide gel

                                                     Superior separation of mid-low
                                                     molecular weight proteins

                                                     Silver staining

                                                     Maximum loading of 1ng protein


Qualitative at best. Method of visualisation is very important.
Liquid Chromatography – Mass spectroscopy




Core heptasaccharide is primarily complex
biantennary type structure
                                                        G0 = zero galactose residues
Licensenced recombinant MAbs generally core
                                                        G1 = one galactose residue
fucosylated with low levels of galactosylation
                                                        G2 = two galactose residues
Outer arms have variable addition of fucose
                                                        F denotes fucosylation
galactose, bisecting N-acetyleglucosamine sialic acid
on the antenna
Circular Dichroism
•    Measures difference in absorbance left hand and
     right hand circularly polarised light

•    Molecules must be chiral

•    Far-UV range used for analysis of secondary
     structure (200-260nm)

•    Near-UV range used for analysis of tertiary
     structure (260-350nm)

•    Use computer program to estimate ratios of
     secondary structures β-sheets, α-helices etc

•    Compare spectra between time points and also
     examine thermal stability
Variable Temperature Circular Dichroism

     Can measure changes in secondary structure as
     a function of changing temperature


     Can identify the melting temperature of a MAB,
     which give information as to the integrity of
     secondary and tertiary structure. Ie. Can identify
     the IMPACT of chemical changes




                              Temperature	
  
                   25°C	
       37.5°C	
        50°C	
     62.5°C	
     75°C	
  
  α-helix	
         5.3	
         5.4	
          5.5	
       5.5	
       6.6	
  
Antiparallel	
     40.1	
        39.9	
         39.7	
      39.4	
      36.4	
  
  Parallel	
        5.4	
         5.4	
          5.4	
       5.4	
       5.5	
  
 Beta-turn	
       17.7	
        17.7	
         17.7	
      17.7	
      18.1	
  
Random Coil	
      34.8	
        34.8	
         34.8	
      34.8	
      34.9	
  
Other


   pH

   Visual appearance

   Colour

   Turbidity
Potency




          Receptor   Cell Line   Clinical
          Studies    Studies     Effect
ICH Q6B




          ELISA
ELISA

 -  Receptor binding studies

 -  Allow one to measure changes
    in binding ability of Fc and
    variable region.

 -  DOES NOT tell us whether
    this binding leads to a cellular
    effect.

 -  Can be carried out quickly at a
    range of temperatures and
    concentrations.
      -  Real system???
Cell based activity studies

-    Want to ensure that results of the assay are representative.

-    Parameters that need to be identified/optimized.

          -    Cell lines: Need cells which express receptor specific to the MAB
          -    Cell numbers, Culture time, Passages
          -    Correct MAB concentration to see a change
          -    What cellular response are we looking for. Ie. Apoptosis

-    Validation is essential. But no instructions on how to do this, but what are
     some key considerations?
Which effect ?               Trastuzumab

 -  As we want the assay to be representative of clinical effect,
    measurement of ultimate effect of the MAB is preffered.

 -  Cell death

 -  Other pathways higher up the cascade could also be monitored.

 -  pAkt

 -  Cellular proliferation
Which effect?             Alemtuzumab




 - Multiple mechanisms of action contribute to clinical efficacy

 - More than one mechanism should be tested.
Establishing an end point
                                                     Conc 1
                                                     Conc 2
                                                     Conc 3
                                                     Base line
                   Baseline




                              Days



   -    Determination of a baseline
   -    Comparison to baseline over time
   -    Meaningful comparison requires high level of confidence in the data
   -    Reducing standard deviation between points is key.
Thank you !


Download available from:     mabstalk.com

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MABs Stability – Analytical Techniques

  • 1. MABs Stability – Analytical Techniques Andrew G Watts PhD. Medicinal Chemistry Group Department of Pharmacy and Pharmacology September 2012
  • 2. Disclosure Glythera Ltd. Founder and Scientific Advisor Bath ASU Scientific Consultant
  • 3. Key questions which need to be answered Which analytical techniques do we need to use to effectively evaluate the stability of MABs ? What do we need to consider when interpreting the results from these techniques? What amount/type of degradation is significant/important? - Acceptance criteria
  • 4. Source Guidance •  International Conference for Harmonization (ICH) •  Harmonization of British, US, Japanese and European Pharmacopeia's •  ICH Q2 R1 Analytical validation •  ICH Q5C Stability Testing of Biotechnological/Biological products •  ICH Q6B Specifications Test Proceedures and Acceptance criteria for bioltechnological/biological products Guidelines generally aimed at the licensing of new drug products.  
  • 5. Scope of Q5C Q5c  -­‐  characterised  proteins  and  polypeptides   their  derivatives  and  products  of  which  they  are  components  and  which  are   isolated  from  tissues,  body  fluids,  cell  cultures,  or  produced  using  rDNA   technology   Ø  cytokines  (interferons,  interleukins,  colony-­‐stimulating  factors,  tumour  necrosis   factors)   Ø  erythropoietins   Ø  plasminogen  activators   Ø  blood  plasma  factors   Ø  growth  hormones  and  growth  factors   Ø  insulins   Ø  monoclonal  antibodies   Ø  vaccines  consisting  of  well-­‐characterised  proteins  or  polypeptides  
  • 6. ICH Q5C : DOES NOT : Provide us with a ‘recipe’ for how to analyse or interpret MAB stability DOES : Outline criteria for a sound approach to designing protocols for determining stability. •  Primary data to support a requested storage period, long-term, real-time and real-condition stability studies •  Preferable NOT to use accelerated/stressed stability testing
  • 7. Stability-Indicating profile §  no single stability-indicating assay or parameter – profiles the stability characteristics of a biotechnological/biological product §  the stability-indicating profile should provide assurance that changes in the : Primary structure Identity Chemical Secondary structure Purity analysis Tertiary structure Quaternary structure Biological Potency Cellular response activity Other characteristics §  the determination of which tests should be included will be product- specific
  • 8. Degradation Pathways Impact upon: Physical •  Denaturation Primary structure •  Aggregation •  Surface adsorption Secondary structure Chemical Tertiary structure •  Disulfide formation/exchange •  Non-reducible cross linking Quaternary structure •  Deamidation •  Isomerization Cellular response •  Oxidation •  Glycosylation
  • 9. Analytical Principle Information/use Advantages/ Disadvantages method SEC Size Quantify mAb and relative purity + separation of main isoforms - Limited mass resolution SDS-PAGE Size Estimate purity and molecular mass + Cheap, fast - Limited information - Limited mass resolution DLS Size Polydispersity, size distribution, + Highly sensitive technique detection of high molecular weight - High polydispersity will affect accuracy aggregates - Cannot resolve short oligomers CD Shape / 3D Estimate ratios of secondary + speed and ease of use structure structures, detect changes in + spectra can be obtained with small volume tertiary structure/ conformation and concentration of antibody -  Expensive instrument -  Diluents and excipients may show significant absorption in far-UV Microflow Size + Count and characterisation of + characterisation allows removal of air and oil morphology aggregates droplets - Reliable shape information above 4µm diameter pH Hydrogen Hydrogen potential of solution + indicative of degradation processes potential - Limited information LC-MS Polarity + mass Charge to mass ratio, separation, +Online desalting and fragment separation characterisation, quantification of + highly detailed information mAb isoforms -  Significant method optimization -  Expensive and requires trained analyst
  • 10. Aggregation  0µm                    0.5µm    10µm    25µm    50µm    500µm   partial unfolding aggregation Wide dynamic range of aggregate types and sizes means that multiple techniques are need to assess this form of degradation.
  • 11. SEC HPLC (Size-Exclusion) Monomer Validation (ICH Q2) Selectivity •  Forced degradation studies Fragments Linearity Aggregates •  Calibration Curves •  Limit of detection •  Limit of quantification Accuracy •  Over 3 concentrations levels (min 9 injections) Precision •  Repeatability of 6 injections (%RSD <2%) Higher MW Lower MW Robustness
  • 12. SEC HPLC (Size-Exclusion) Day   HMW-4-% HMW-3-% HMW-2-% HMW-1-% Monomer-%           A   0.00 ± 0.00   0.00 ± 0.00   0.00 ± 0.00   1.76 ± 0.24   98.25 ± 0.24   B   0.00 ± 0.00   0.00 ± 0.00   0.21 ± 0.02   2.18 ± 0.10   97.61 ± 0.12   C   0.00 ± 0.00   0.00 ± 0.00   0.25 ± 0.02   2.40 ± 0.06   97.36 ± 0.09   D   0.00 ± 0.00   0.00 ± 0.00   0.18 ± 0.11   2.14 ± 0.41   97.68 ± 0.52   E   0.00 ± 0.00   0.00 ± 0.00   0.21 ± 0.01   2.25 ± 0.03   97.51 ± 0.05   F   0.00 ± 0.00   0.00 ± 0.00   0.19 ± 0.01   2.27 ± 0.02   97.54 ± 0.02   G   0.00 ± 0.00   0.00 ± 0.00   0.23 ± 0.01   2.34 ± 0.06   97.44 ± 0.07   H   0.00 ± 0.00   0.00 ± 0.00   0.22 ± 0.01   2.30 ± 0.03   97.48 ± 0.04   I   0.18 ± 0.36   0.17 ± 0.01   0.82 ± 0.04   1.39 ± 0.08   97.46 ± 0.34   J   0.00 ± 0.00   0.21 ± 0.01   1.00 ± 0.04   1.54 ± 0.07   97.25 ± 0.08   Linearity of response and LOD, LOQ are crucial. Low molecular weight aggregates can be reversible - constant temperature
  • 13. Dynamic Light Scattering (DLS) •  Sample is illuminated with a laser •  Measures time dependant fluctuations in the intensity of scattered light •  Fluctuations occur because particles are constantly undergoing Brownian motion •  Effectively measures velocity of molecules which can be converted on to an equivalent hydrodynamic radius. The size distribution obtained is a plot of the relative intensity of light scattered by particles in monomer aggregate various size classes.   Oligomeric High MW Oligomeric High MW Z-Ave Species Aggregates Species Aggregates (r.nm)   PdI   %PD   mean r.nm   mean r.nm   (%Volume)   (% Volume)   Day A   7.98   0.07   27.33   8.67   0.00   100.00   0.00   Day D   8.27   0.10   31.56   8.75   2584.67   100.00   0.00   Day C   8.03   0.07   25.84   8.69   0.00   100.00   0.00   Day D   8.05   0.08   28.27   8.79   0.00   100.00   0.00   Day E   7.99   0.05   23.15   8.53   0.00   100.00   0.00   Day F   8.02   0.07   26.12   8.67   0.00   100.00   0.00   Day G   8.87   0.17   41.58   9.63   2323.33   99.98   0.02   Day H   7.97   0.05   22.53   8.50   0.00   100.00   0.00   Day I   7.95   0.05   21.93   8.49   0.00   100.00   0.00   Day J   8.09   0.08   27.97   8.79   0.00   100.00   0.00  
  • 14. Microflow Imaging (Particle counting) aggregated protein silicone oil MFI uses high resolution camera to detect insoluble particles in a flow cell •  Captures numerous frames per second •  Software crops particles from each raw image and produces collage •  Results must be corrected using statistical filters to distinguish silicone oil droplets and micro air bubbles micro-air bubble   Particles (1000/ml) ± SD   X mg/ml   > 1µm   >2µm   >10µm   >25µm   Day A   275 ± 102   45 ± 29   5 ± 3   0.0 ± 0.1   Day B   441 ± 14   194 ± 10   10 ± 2   0.0 ± 0.2   Day C   166 ± 21   56 ± 14   0.3 ± 3   0.0 ± 0.4  
  • 15. SDS – Page (Elecrophoresis) Native Tris Acetate 3-8% polyacrilamide gel Better separation of high molecular weight proteins (300-100kDa) Coomassie Staining Maximum loading of 0.5ug protein Reducing Bis-Tris 10% polyacrilamide gel Superior separation of mid-low molecular weight proteins Silver staining Maximum loading of 1ng protein Qualitative at best. Method of visualisation is very important.
  • 16. Liquid Chromatography – Mass spectroscopy Core heptasaccharide is primarily complex biantennary type structure G0 = zero galactose residues Licensenced recombinant MAbs generally core G1 = one galactose residue fucosylated with low levels of galactosylation G2 = two galactose residues Outer arms have variable addition of fucose F denotes fucosylation galactose, bisecting N-acetyleglucosamine sialic acid on the antenna
  • 17. Circular Dichroism •  Measures difference in absorbance left hand and right hand circularly polarised light •  Molecules must be chiral •  Far-UV range used for analysis of secondary structure (200-260nm) •  Near-UV range used for analysis of tertiary structure (260-350nm) •  Use computer program to estimate ratios of secondary structures β-sheets, α-helices etc •  Compare spectra between time points and also examine thermal stability
  • 18. Variable Temperature Circular Dichroism Can measure changes in secondary structure as a function of changing temperature Can identify the melting temperature of a MAB, which give information as to the integrity of secondary and tertiary structure. Ie. Can identify the IMPACT of chemical changes Temperature   25°C   37.5°C   50°C   62.5°C   75°C   α-helix   5.3   5.4   5.5   5.5   6.6   Antiparallel   40.1   39.9   39.7   39.4   36.4   Parallel   5.4   5.4   5.4   5.4   5.5   Beta-turn   17.7   17.7   17.7   17.7   18.1   Random Coil   34.8   34.8   34.8   34.8   34.9  
  • 19. Other pH Visual appearance Colour Turbidity
  • 20. Potency Receptor Cell Line Clinical Studies Studies Effect
  • 21. ICH Q6B ELISA
  • 22. ELISA -  Receptor binding studies -  Allow one to measure changes in binding ability of Fc and variable region. -  DOES NOT tell us whether this binding leads to a cellular effect. -  Can be carried out quickly at a range of temperatures and concentrations. -  Real system???
  • 23. Cell based activity studies -  Want to ensure that results of the assay are representative. -  Parameters that need to be identified/optimized. -  Cell lines: Need cells which express receptor specific to the MAB -  Cell numbers, Culture time, Passages -  Correct MAB concentration to see a change -  What cellular response are we looking for. Ie. Apoptosis -  Validation is essential. But no instructions on how to do this, but what are some key considerations?
  • 24. Which effect ? Trastuzumab -  As we want the assay to be representative of clinical effect, measurement of ultimate effect of the MAB is preffered. -  Cell death -  Other pathways higher up the cascade could also be monitored. -  pAkt -  Cellular proliferation
  • 25. Which effect? Alemtuzumab - Multiple mechanisms of action contribute to clinical efficacy - More than one mechanism should be tested.
  • 26. Establishing an end point Conc 1 Conc 2 Conc 3 Base line Baseline Days -  Determination of a baseline -  Comparison to baseline over time -  Meaningful comparison requires high level of confidence in the data -  Reducing standard deviation between points is key.
  • 27. Thank you ! Download available from: mabstalk.com