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(Bioeconomyreport) 21. 글로벌 항체치료제 시장 및 기술개발 동향
(Bioeconomyreport) 21. 글로벌 항체치료제 시장 및 기술개발 동향
(Bioeconomyreport) 21. 글로벌 항체치료제 시장 및 기술개발 동향
Issue 21
글로벌 항체치료제 시장 및
기술개발 동향
글로벌 항체치료제 시장 및
기술개발 동향
June 2020. Issue 21
김성우 무한아이피씨 요약
자문위원
이은교 한국생명공학연구원 1986년 Ortho Biotech社의 항체치료제 Orthoclone OKT3가 신장이식 거부반응 치료제로
센터장 써 미 FDA로부터 최초 승인된 이래 30년 이상의 시간이 흘렀으며, 그 기간 동안 항체공학 기
술은 비약적으로 진화해 왔다. 그 결과, 항체치료제 시장은 최근 수년간 개발된 신약들 가운데
1장. 서론
반응의 일시적 수급불균형 상태를 해소하고, 다시금 건강한 상태로 회복시키지만, 암이나 면
강은 더욱 악화된다.
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글로벌 항체치료제 시장 및 기술개발 동향
의해 생성되는 항체가 아닌, 외부로부터 인위적으로 생산한 항체, 이른바 유전공학 기법을 활
약적으로 진화해 왔으며, 질환군도 암이나 관절염외에 노인성 황반변성이나 당뇨병성 망막변
이 새롭게 개발되었다.
기여하고 있다[1].
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Innovating Data into Strategy and Business
[그림 1] Timeline from 1975 showing the successful development of therapeutic antibodies and their applications
Many biotech companies that promised antibodies as anticancer "magic bullets" were launched from 1981 to 1986. The height of the line
and numerical annotations represent the estimated market value of mAb therapeutics in each indicated year (shown as billions of US dollars).
Antibodies colored in red represent the top 10 best-selling antibody drugs in 2018. Ab, Antibody; ALCL, systemic anaplastic large-cell lymphoma;
aTTP, acquired thrombotic thrombocytopenic purpura; BC, breast cancer; CD, cluster of differentiation; CGRP, calcitonin gene-related peptide;
CGRPR, alcitonin gene-related peptide receptor; CRC, colorectal cancer; CTLA-4, cytotoxic T-lymphocyte-associated protein 4; EGFR, epidermal
growth factor receptor; FGF, fibroblast growth factor; GC, gastric cancer; GD2, disialoganglioside GD2; HER2, human epidermal growth factor
receptor 2; IgE, immunoglobulin E; IL, interleukin; IL-17R, interleukin-17 receptor; mAb, monoclonal antibody; MCC, merkel-cell carcinoma;
NSCLC, non-small cell lung cancer; PD-1, programmed cell death protein 1; PD-L1, programmed death-ligand 1; TNFα, tumor necrosis facotr α;
RA, rheumatoid arthritis; RANKL, receptor activator of nuclear factor kappa-B ligand; VEGF-A, vascular endothelial growth factor-A; VEGFR2,
vascular endothelial growth factor receptor 2; vWF, von Willebrand factor; XLH, X-linked hypophosphatemia.
출처: Lu RM et al. Development of therapeutic antibodies for the treatment of diseases. Journal of Biomedical Science. 2020;27:1-30
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글로벌 항체치료제 시장 및 기술개발 동향
다[표 1].
Melanoma (2015)
Nivolumab Non-small cell lung cancer (2015)
2 Bristol-Myers Squibb $7.6bn
(Opdivo) Renal cell carcinoma (2015)
Head and neck squamous cell (2016)
Melanoma (2014)
Head and neck cancer (2016)
Pembrolizumab Non-small cell lung caccer (2015)
3 Merck & Co $7.2bn
(Keytruda) Lymphoma (2018)
Cervical cancer (2018)
Microsatellite instability-high cancer (2018)
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Innovating Data into Strategy and Business
Psoriasis (2009)
Ustekinumab
8 Psoriatic arthritis (2013) Johnson & Johnson $5.2bn
(Stelara)
Crohn’s Disease (2016)
출처: Lu RM et al. Development of therapeutic antibodies for the treatment of diseases. Journal of Biomedical Science. 2020;27:1-30
한편, 항체치료제 시장의 폭발적 성장에 힘입어 다양한 질환에 대한 항체치료제가 시판되고
있는데, 이들의 년도별 허가건수, 타겟질환, 항체치료제의 분자적 특성, 제조사별 점유율 및
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글로벌 항체치료제 시장 및 기술개발 동향
(A) Following a decade of stagnation (2002-2012) with an average of 1.6 new mAbs approved per year between 2002 and 2012, recently the
regulatory bodies in the USA and the EU have streamlined approvals, resulting in 35 mAbs and 11 biosimilars entering the market since 2013. (B)
While mAbs are increasingly used for broader targets, oncology and hematology remain the most prevalent medical applications. (C) Inspection
of the molecular structure of mAbs and production organisms of choice reveals the human nature of mAbs, which are mostly engineered on the
IgG1 subclass with a kappa light chain and are produced almost exclusively using mammalian cells. (D) The mAb market is enjoying a healthy
pipeline and is expected to grow at a faster pace, reaching a valuation of USD 130-200bn. (E) Nonetheless, new companies are unlikely to take
over the market, which is currently dominated by seven companies. (F) Finally, Asia is expected to increase its share of mAb manufacturing, which
is currently performed predominantly (close to 93%) in the USA and Europe.
출처: Grilo AL, Mantalaris A. The Increasingly Human and Profitable Monoclonal Antibody Market. Trends Biotechnol. 2019;37:9–16
관련 질환들이 10% 미만에서 차례로 순위를 지키고 있는 것으로 분석되었다. 또한, 출시된
항체치료제들 가운데 약 80%는 IgG1 아형의 중쇄를 근간으로 하며, 70%는 경쇄부위가
세포가 전체의 60% 수준의 빈도로 활용되고 있으며, 면역원성 관점에서 완전인간항체가 전
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Innovating Data into Strategy and Business
3장. 항체치료제 허가 및 개발 현황
Prevention of
Centocor/ Eli Chimeric IgG1
Abciximab Reopro GPIIb/IIIa Hybridoma blood clo ts in 1994
Lilly/ Janssen Fab
angiopl asty
Biogen/
MabThera,
Rituximab Roche/ CD20 ChimericI gG1 Hybridoma NHL 1997
Rituxan
Genentech
Prevention
MedImmune/ of respiratory
Palivizumab Synagis RSV Humanized IgG1 Hybridoma 1998
AbbVie syncytial vir us
infection
Infliximab Remicade Janssen TNFα Chimeric IgG1 Hybridoma Crohn’s disease 1998
Roche/
Trastuzumab Herceptin HER2 Humanized IgG1 Hybridoma Breast cancer 1998
Genentech
Berlex/
Campath,
Alemtuzumab Genzyme/ CD52 Humanized IgG1 Hybridoma CML 2001
Lemtrada
Millennium
Biogen/
Ibritumomab
Zevalin Schering AG/ CD20 Murine IgG1 Hybridoma NHL 2002
tiuxetan
Spectrum
Roche/
Genentech/
Omalizumab Xolair IgE Humanized IgG1 Hybridoma Asthma 2003
Novartis/
Tanox
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글로벌 항체치료제 시장 및 기술개발 동향
BMS/
Colorectal
Cetuximab Erbitux Merck&Co/ Eli EGFR Chimeric IgG1 Hybridoma 2004
cancer
Lilly/ ImClone
Roche/ Colorectal
Bevacizumab Avastin VEGF-A Humanized IgG1 Hybridoma 2004
Genentech cancer
Biogen/
Natalizumab Tysabri ITGA4 Humanized IgG4 Hybridoma Multiple sclerosis 2004
Elan
Transgenic Colorectal
Panitumumab Vectibix Amgen EGFR Human IgG2 2006
mice cancer
Roche/
Humanized IgG1 Macular
Ranibizumab Lucentis Genentech/ VEGF-A Hybridoma 2006
Fab degeneration
Novartis
Paroxysmal
Humanized
Eculizumab Soliris Alexion C5 Hybridoma nocturnal 2007
IgG2/4
hemoglobin uria
Medarex/
Transgenic
Ustekinumab Stelara Centocor/ IL-12/23 Human IgG1 Psoriasis 2009
mice
Janssen
Transgenic Muckle-Wells
Canakinumab Ilaris Novartis IL-1β Human IgG1 2009
mice syndrome
Rheumatoid and
Centocor/ Transgenic psoriatic arthritis,
Golimumab Simponi TNFα Human IgG1 2009
Janssen mice ankylosing
spondylitis
Transgenic
Denosumab Xgeva, Prolia Amgen RANKL HumanIgG2 Bone loss 2010
mice
Hodgkin
lymphoma,
Brentuximab SG/ Chimeric IgG1;
Adcetris CD30 Hybridoma systemic 2011
vedotin Takeda ADC
anaplastic large
cell lymphoma
Roche/
Pertuzumab Perjeta HER2 Humanized IgG1 Hybridoma Breast cancer 2012
Genentech
Roche/
Trastuzuma Humanized IgG1;
Kadcyla Genentech/ HER2 Hybridoma Breast cancer 2012
bemtansine ADC
ImmunoGen
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Innovating Data into Strategy and Business
Centocor/ Castleman
Siltuximab Sylvant IL-6 Chimeric IgG1 Hybridoma 2014
Janssen disease
Ramucirumab Cyramza EliLilly/ ImClone VEGFR2 Human IgG1 Phage display Gastric cancer 2014
Genentech/
Ulcerative colitis,
Vedolizumab Entyvio Millennium/ α4β7integrin Humanized IgG1 Hybridoma 2014
Crohn disease
Takeda
Reversal of
dabigatran-
Idarucizumab Praxbind BI Dabigatran HumanizedFab Hybridoma 2015
induced
anticoagulation
Necitumumab Portrazza EliLilly/ ImClone EGFR Human IgG1 Phage display NSCLC 2015
United
Dinutuximab Unituxin GD2 Chimeric IgG1 Hybridoma Neuroblastoma 2015
Therapeutics
Transgenic
Secukinumab Cosentyx Novartis IL-17α Human IgG1 Psoriasis 2015
mice
Severe
Mepolizumab Nucala Centocor/ GSK IL-5 Humanized IgG1 Hybridoma eosinophilic 2015
asthma
Regeneron/ Transgenic
Alirocumab Praluent PCSK9 Human IgG1 High cholesterol 2015
Sanofi mice
Amgen/
Transgenic
Evolocumab Repatha Amgen Astellas PCSK9 Human IgG2 High cholesterol 2015
mice
BioPharma
Multiple
Elotuzumab Empliciti BMS/ AbbVie SLAMF7 Humanized IgG1 Hybridoma 2015
myeloma
Celltech/ UCB/
Cinqaero,
Reslizumab Schering- IL-5 HumanizedIgG4 Hybridoma Asthma 2016
Cinqair
Plough/Teva
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글로벌 항체치료제 시장 및 기술개발 동향
Prevention of
Clostridium
Transgenic Clostridiu m
Bezlotoxumab Zinplava Merck&Co difficile Human IgG1 2016
mice difficile infection
enterotoxin B
recurrence
Roche/
Atezolizumab Tecentriq PD-L1 Humanized IgG1 Hybridoma Bladder cancer 2016
Genentech
Prevention of
Elusys
Obiltoxaximab Anthim B.anthrasis PA Chimeric IgG1 Hybridoma inhalation al 2016
Therapeutics
anthrax
Inotuzumab
Besponsa Wyeth/ Pfizer CD22 Humanized IgG4 Hybridoma ALL 2017
ozogamicin
MedImmune/
Amgen/ Kyowa
Transgenic
Brodalumab Siliq, Lumicef Hakko Kirin/ IL-17R Human IgG2 Plaque psoriasis 2017
mice
AstraZeneca/
Valeant
MorphoSys/
Guselkumab Tremfya IL-23p19 Human IgG1 Phage display Plaque psoriasis 2017
Janssen
Regeneron/ Transgenic
Dupilumab Dupixent IL-4Rα Human IgG4 Atopic dermatitis 2017
Sanofi mice
Regeneron/ Transgenic
Sarilumab Kevzara IL-6R Human IgG1 RA 2017
Sanofi mice
Merkel cell
Avelumab Bavencio Merck/ Pfizer PD-L1 Human IgG1 Phage display 2017
carcinoma
Biogen/ Roche/
Ocrelizumab Ocrevus Genentech/ CD20 Humanized IgG1 Hybridoma Multiple sclerosis 2017
SIGMA-TAU
Humanized IgG4,
Emicizumab Hemlibra Chugai/ Roche FactorIXa X Hybridoma Hemophilia A 2017
bispecific
MedImmune/
Kyowa
Benralizumab Fasenra IL-5Rα Humanized IgG1 Hybridoma Asthma 2017
Hakko Kirin/
AstraZeneca
MedImmune/ Transgenic
Durvalumab Imfinzi PD-L1 Human IgG1 Bladder cancer 2017
AstraZeneca mice
Kyowa
Transgenic X-linked
Burosumab Crysvita Hakko Kirin/ FGF23 Human IgG1 2018
mice hypophosphatemia
Ultragenyx
Hereditary
Lanadelumab Takhzyro Dyax Plasma kallikrein Human IgG1 Phage display angioedema 2018
attacks
Mycosis
Mogamuli Kyowa Hakko
Poteligeo CCR4 Humanized IgG1 Hybridoma fungoides or 2018
zumab Kirin
Sezary syndrome
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Innovating Data into Strategy and Business
Transgenic Migraine
Erenumab Aimovig Novartis CGRPR Human IgG2 2018
mice prevention
Migraine
Galcanezumab Emgality Eli Lilly CGRP Humanized IgG4 Hybridoma 2018
prevention
Merck&Co/ Sun
Tildrakizumab Ilumya IL-23p19 Humanized IgG1 Hybridoma Plaque psoriasis 2018
Pharma
Transgenic
Cemiplimab Libtayo Regeneron PD-1 Human mAb cSCC 2018
mice
Primary
hemophagocytic
Emapalumab Gamifant NovImmmune IFNγ Human IgG1 Phage display 2018
lymphohis
tiocytosis
Migraine
Fremanezumab Ajovy Teva CGRP Humanized IgG2 Hybridoma 2018
prevention
Taimed
Ibalizumab Trogarzo Biologics / Thera CD4 Humanized IgG4 Hybridoma HIV infection 2018
technologies
Paroxysmal
humanized
Ravulizumab Ultomiris Alexion C5 Hybridoma nocturnal he 2018
IgG2/4
moglobinuria
Acquired
von Will ebrand Humanized thrombotic
Caplacizumab Cablivi Ablynx Hybridoma 2019
factor Nanobody thrombocyto
penic purpura
Osteoporosis
in postmenop
Amgen/
Romosozumab Evenity Sclerostin Humanized IgG2 Hybridoma ausal women at 2019
UCB
increased risk of
fract ure
BI/
Risankizumab Skyrizi IL-23p19 Humanized IgG1 Hybridoma Plaque psoriasis 2019
AbbVie
Macular
Brolucizumab Beovu Novartis VEGF-A HumanizedscFv Hybridoma$ 2019
degeneration
Crizanlizumab Adakveo Novartis P-selectin Humanized IgG2 Hybridoma Sickle cell disease 2019
* Marketing end date on July 30th, 2011; # Year of the first US FDA approval & Indication of the first US FDA approval; $ Rabbit hybridoma technology.
출처 : Lu RM et al. Development of therapeutic antibodies for the treatment of diseases. Journal of Biomedical Science. 2020;27:1-30
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글로벌 항체치료제 시장 및 기술개발 동향
Phase II, Phase II/III, Phase III)에서 임상개발 중에 있다[1, 4]. [그림 3]에서는 후기 임상단
수 있으며, 항암제 시장의 성장과 더불어 종양을 타겟팅하는 후보물질에 대한 임상도 증가하
100
■ Cancer
Number of mAbs in late-stage studies
80
■ Non-Cancer
60
40
20
0
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Year of article publication
2020 values based on data publicly available as of December 5, 2019; other data from ‘Antibodies
to watch’ articles published in mAbs starting in 2010. “Late-stage”clinical studies include pivotal
or registrational Phase 2, Phase 2/3 or Phase 3 studies. Biosimilar antibody and Fc fusion protein
products were excluded. A table of antibodies in late-stage studies sponsored by commercial firms is
maintained by The Antibody Society.
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Innovating Data into Strategy and Business
적 수준의 차이를 도식하여 보여주고 있으며, [그림 5]에서는 이들의 개발을 위한 일반적인
(A) The murine monoclonal antibody. (B) The chimeric monoclonal antibody: variable regions are of
murine origine, and the rest of the chains are of human origin. (C) Humanized monoclonal antibody:
only includes the hypervariable segments of murine origin. (D) Fully human monoclonal antibody.
CH: domains of the constant region of the heavy chain; CL: constant domain of the light chain; Fab
and Fc: fragments resulting from proteolysis; VH: variable domain of the heavy chain; VL: variable
domain of the light chain.
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글로벌 항체치료제 시장 및 기술개발 동향
(A) The traditional mouse hybridoma technique starts by immunization of mice with desired antigens to trigger an immune reponse. Harvested
splenocytes are fused with myeloma cells to produce hybridoma cells that persistently secrete antibodies. After the screening, selected leads
are used to generate chimeric or humanized antibodies. (B) Phage display. A human phage-displayed human antibody library is used to select
antigens of interest. After 3-5 rounds of biopanning, immuno-positive phage clones are screened by ELISA; then DNA sequences are analyzed to
construct and express human IgGs. (C) Transgenic mouse. Similar to the mouse hybridoma technique or single B cell methods. (D) The single B
cell technique. From infected or vaccinated donors, PBMCs are prepared for isolation of suitable B cells by flow cytometry. Following the RT-PCR,
VH and VL information of each B cell informs the generation of human mAbs.
출처: Lu RM et al. Development of therapeutic antibodies for the treatment of diseases. Journal of Biomedical Science. 2020;27:1-30
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Innovating Data into Strategy and Business
[표 3].
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글로벌 항체치료제 시장 및 기술개발 동향
Prolia,
7 Denosumab Amgen 2010 RANKL XenoMouse
Xgeva
Veloclmmune
12 Alirocumab Praluent Sanofi / Regeneron 2015 PCSK9
Mouse
Veloclmmune
21 Dupilumab Dupixent Sanofi / Regeneron 2017 IL-4R
Mouse
Medimmune /
22 Durvalumab Imfinzi 2017 PD-L1 XenoMouse
AstraZeneca
Veloclmmune
24 Sarilumab Kevzara Sanofi / Regeneron 2017 IL-6R
Mouse
Veloclmmune
26 Cemiplimab Libtayo Regeneron 2018 PD-1
Mouse
Moxetumomab MedImmune/
28 Lumoxiti 2018 CD22 Phage display
pasudodox AstraZeneca
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Innovating Data into Strategy and Business
scFv library)를 구축해야 한다. scFv가 파아지의 표면에 발현된 파아지 라이브러리는 말초혈
에 도식화되어 있다.
(A) Outline of the procedure for constructing a phage-displayed antibody (Fab or scFv) library. (B) Structure of IgG molecule. Fab consists of the
light chain and the first two domains of the heavy chain. scFv is composed of the variable heavy (VH) and variable light (VL) domains joined by a
short flexible polypeptide linker. (C) Biopanning with a phage-displayed library. Initial pools of antibodies on the surface of phages are applied to
antigens immobilized on a solid surface, e.g., ELISA plates or magnetic beads. Non-specific phages are removed by stringent washing. Antigen-
bound phages are eluted and re-infected into E.coli to produce a subset of phages for the next cycle of panning. After several rounds, the
antigen-binding clones are sufficiently enriched and individual clones can be selected for further analysis.
출처: Lu RM et al. Development of therapeutic antibodies for the treatment of diseases. Journal of Biomedical Science. 2020;27:1-30
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글로벌 항체치료제 시장 및 기술개발 동향
스플레이(yeast display), RNA 디스플레이 (RNA display), DNA 디스플레이 (DNA display)
하여 제작한 형질전환 마우스 활용기술이 있다[그림 5, C]. 이렇게 제작된 마우스에 질병유
질전환 마우스 제작에 대한 원천 특허를 보유하고 있으며, 다수의 회사가 이 기술을 활용하여
점에서 감염성 질환과 같이 촌각을 다투는 경우에는 비효율적인 경우가 많다. 이러한 경우에
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Innovating Data into Strategy and Business
4-2. 항체치료제 효능 향상 기술
4.2.2. Fc engineering 기술
항원결합부위 외에 항체의 Fc domain에, 돌연변이나 당쇄수식 변화를 유도하여 항체의존
등을 최적화하고 있다. Glycart는 당쇄(sugar chain) 전이효소의 일종인 GnT III 유전자를 항
sugar의 조성을 높여줌으로써 ADCC를 증가시키는 기술을 보유하고 있다. Biowa는 fucose
ADC)가 기대를 모으고 있다. 가령, 현재까지 총 8개 품목의 ADC가 미 FDA 시판승인을 거
19
글로벌 항체치료제 시장 및 기술개발 동향
완전한 IgG 형태가 아닌 항체단편 형태로 승인된 치료용 항체로는 Lucentis와 ReoPro (둘
다 Fab 형태) 등이 있으며, 다수의 항체단편 형태의 치료제가 전임상 및 임상에 올라와 있
다. 이러한 항체단편의 형태에는 전통적인 Fab, scFv 형태와, camelid VHH (nanobody,
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Innovating Data into Strategy and Business
[그림 7] Analysis of new combination trials started in the past two years
When trials targeting VEGF and VEGFR were pooled together under “VEGFR-axis”, this mechanism-of-
action becomes the third largest target of PD-1/PD-L1 combination trials that were opened in the past
two years.
출처: Carter Paul J., Lazar Greg A. Nex generation antibody drugs : pursuit of the high-hanging fruit.
Nature Reviews Drug Discovery. 2018;17197-223
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글로벌 항체치료제 시장 및 기술개발 동향
독성 문제가 야기될 수 있어 암세포 선별적 항체와의 결합을 통하여 시너지 효과를 기대할
가 인식하여 세포내 이동되고 항체에 링커로 연결된 약물이 방출되어 암세포 사멸을 유도하
체가 개발되고 있다[6].
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23
June 2020. Issue 21
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