Immunology · Transplant, tumors and immunotherapy
Monoclonal antibodies and biologics: naming and targets !
- Topic
Lab-made antibodies hit one target, such as TNF, CD20 or HER2; the end of the drug name tells you what kind of molecule it is.
Updated 2026-11-01
What it is
Monoclonal antibodies are identical antibodies made in the lab against a single target. They block cytokines or receptors, mark cells for destruction, or carry toxins and drugs to a cell. Fusion proteins that join a receptor to an antibody tail (-cept) work in a similar way. Knowing the target predicts both the use and the main risk.
Key facts
- The syllable before the ending hints at the target area: -lim- immune system, -tum- tumor, -cir- cardiovascular, -kin- interleukin (older scheme).
- Antibodies can be naked (block or mark the target), conjugated to a drug or toxin, or bispecific, joining two targets such as CD19 and CD3 (blinatumomab).
- Mouse or chimeric antibodies are more likely to trigger anti-drug antibodies and infusion reactions.
Biologics to know: target and main use
| Drug | Target | Main uses | Key risk |
|---|---|---|---|
| Infliximab, adalimumab, golimumab, certolizumab | TNF-α | Rheumatoid arthritis, Crohn disease, ulcerative colitis, psoriasis, ankylosing spondylitis | TB reactivation, serious infections, hepatitis B reactivation |
| Etanercept (-cept) | TNF (soluble receptor decoy) | Rheumatoid arthritis, psoriasis | TB reactivation, infections |
| Rituximab | CD20 (B cells) | B-cell lymphomas, CLL, rheumatoid arthritis, vasculitis | Hepatitis B reactivation, PML, infusion reactions |
| Trastuzumab | HER2 (ERBB2) | HER2-positive breast and gastric cancer | Cardiomyopathy (reduced ejection fraction) |
| Bevacizumab | VEGF-A | Colorectal, lung and ovarian cancer; some eye diseases | Hypertension, bleeding, proteinuria, poor wound healing, GI perforation |
| Cetuximab, panitumumab | EGFR | RAS wild-type colorectal cancer, head and neck cancer | Acne-like rash, low magnesium |
| Omalizumab | IgE | Severe allergic asthma, chronic urticaria | Anaphylaxis (rare) |
| Mepolizumab; dupilumab | IL-5; IL-4 receptor α | Eosinophilic asthma; atopic dermatitis and asthma | Injection-site reactions; conjunctivitis (dupilumab) |
| Tocilizumab | IL-6 receptor | Rheumatoid arthritis, giant cell arteritis, cytokine release syndrome | Infections, high lipids, liver enzyme rise |
| Ustekinumab; secukinumab | IL-12/IL-23 p40; IL-17A | Psoriasis, Crohn disease (ustekinumab), psoriatic arthritis | Infections; secukinumab can worsen inflammatory bowel disease |
| Natalizumab | α4 integrin | Multiple sclerosis, Crohn disease | PML (JC virus) |
| Eculizumab, ravulizumab | Complement C5 | Paroxysmal nocturnal hemoglobinuria, atypical HUS | Meningococcal infection |
| Denosumab | RANKL | Osteoporosis, bone metastases | Low calcium, jaw osteonecrosis |
| Abciximab | Platelet GPIIb/IIIa | Prevention of thrombosis during coronary intervention (historic) | Bleeding, thrombocytopenia |
Clinical notes
- Before any anti-TNF or B-cell–depleting biologic, patients are screened for latent tuberculosis, hepatitis B and often hepatitis C and HIV; in Colombia the TB screen is especially important.
- Live vaccines are avoided during treatment with most biologics.
Test yourself
Think of the answer, then tap the question to see it.
What does the ending -zumab tell you about a monoclonal antibody?
It is humanized: mostly human, with only the antigen-binding loops from mouse.
Which infection must be screened for before starting infliximab or adalimumab?
Latent tuberculosis (and hepatitis B), because TNF blockade can reactivate them.
What is the target of rituximab and which viral reactivation is a major risk?
CD20 on B cells; hepatitis B reactivation (and PML from JC virus).
What does the suffix -cept mean, and give an example?
A fusion protein of a receptor with an antibody Fc tail, such as etanercept (TNF receptor) or abatacept (CTLA-4).
Which monoclonal antibody against complement requires meningococcal vaccination?
Eculizumab (and ravulizumab), which block C5 and the membrane attack complex.
Related
- TNF-α
- Antibody structure and isotypes (IgG, IgA, IgM, IgE, IgD)
- CD markers: the table to know
- Immunosuppressants by mechanism (classes)
- Tumor immunology and checkpoint inhibitors
- Secondary immunodeficiency: HIV, malnutrition, drugs, asplenia
Related conditions
Microorganisms
In Pharmacology
Educational content on the immune system; not a treatment or individual vaccination guide and no substitute for a health professional's advice. No doses are given.
Sources: Monoclonal Antibodies (National Cancer Institute (NCI), 2026); International Nonproprietary Names Programme and Classification of Medical Products (World Health Organization (WHO), 2026); Risk Factors for Meningococcal Disease (Centers for Disease Control and Prevention (CDC), 2026).
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