**Author details**

*Monoclonal Antibodies*

Immune status modification as strategy of cancer therapy does hold a significant place. Although, the conventional cancer treatments such as surgery, chemotherapy, and radiotherapy are still being referred to as the prominent ones, for some cancer types, immunotherapies are considered as first-line of treatment. One of the most important discoveries in the last several years in immunotherapy has been the development of immune checkpoint inhibitor, monoclonal antibodies that promote antitumor activity. T cells are a form of lymphocyte which are produced within the thymus and performs a crucial function in stimulating body's immune reaction to combat most cancers. They apprehend the overseas particles (antigens) with the aid of using particularly variable T cell receptor. Unlike antibody, the TCR cannot bind antigen and as a substitute it wishes to have peptides of the antigen proven to it with the aid of using an antigen presenting cell (APC). The molecules at the APC that gift the antigen are called as major histocompatibility complexes (MHC). Many stimulatory alerts also are wanted at this time. B7 is a form of peripheral membrane protein observed on activated antigen-providing cells (APC). This B7 on an APC can bind to cytotoxic T-lymphocyte-related antigen 4 (CTLA-4) developing an inhibitory sign and TCR activation. Once the activated T-cell receptor is within the tumor surroundings it is able to apprehend the antigen supplied with the aid of APC within the tumor. At this time, the programmed cell death protein 1 (PD-1) receptor also sends an inhibitory signal to the T-cell when the receptor binds to programmed cell death 1 ligand 1 (PD-L1), that's regularly expressed on tumor cells. Monoclonal antibodies act by inhibiting the binding PD-1 to PD-L1 and thereby boost body's immune response against the tumor cells. Checkpoint inhibitors specifically goal PD-1/PD-L1) and CTLA4 Immune checkpoint efficacy is stricken by diverse factors, among which are tumor genomics, host germline genetics, PD-L1 levels, and intestine microbiome. Generally, in tumors, mutated or incorrectly expressed proteins are processed through the immunoproteasome into peptides which can be commonly loaded onto MHC molecules, which similarly now no longer usually are capable of eliciting CD8+ T cell reaction. This may also cause producing MHC-supplied immunogenic neoepitopes. It turned into proven, that after the intratumor heterogeneity rises, neoantigen-expressing clones emerge as greater homogenous with the differential expression of PD-L1. There are number of FDA approved monoclonal antibodies, that are considered

for the treatment of Urology oncology. These have been detailed in the **Table 1** and include FDA-approved PD-1 inhibitors such as nivolumab, pembrolizumab, cemiplimab, and FDA-approved PD-L1 such as atezolizumab, avelumab, and durvalumab. But all the open literatures do believe that combinatorial strategies with immune checkpoint therapies may provide a better survival benefit which have been demonstrated in various clinical trials. These can be in combination with radiation therapy, tyrosine kinase inhibitors and also many chemotherapeutic drugs. However, the response to immunotherapy with monoclonal antibodies varies subjectively and hence research into PD-L1 expression, gene signature expression, messenger RNA subtype, mutational and neoantigen load is essential to determine the varying response to monoclonal antibody immunotherapy. Although older modalities of treatment for cancer, has been extensively exploited, array of new drugs that offer hope of not only prolonging life but also curing significantly more

patients in the future bring a ray of hope to the scientific world.

The authors declare conflict of interest as None.

**8. Conclusion**

**134**

**Conflict of interest**

Maya Kulshekar1 , Shridhar C. Ghagane2 \*, Sridevi I. Puranik3 , Rajendra B. Nerli4 and Murigendra B. Hiremath<sup>5</sup>

1 Department of Biochemistry, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Belagavi, Karnataka, India

2 Division of Urologic-Oncology, Department of Urology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India

3 Department of Zoology, KLES B.K. Arts, Science and Commerce College, Chikodi, Karnataka, India

4 Department of Urology, JN Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), JNMC Campus, Belagavi, Karnataka, India

5 Department of Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India

\*Address all correspondence to: shridhar.kleskf@gmail.com

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