What Are the Risks of Handling Monoclonal Antibodies?
The risks of exposure to antineoplastic drugs have been a concern since the 1970s and are now well-established.5 Conjugated monoclonal antibodies are considered hazardous drugs because they are bound to cytotoxic substances or radioisotopes. However, naked mAbs don't meet the criteria to be tested as hazardous drugs.8
Although monoclonal antibodies are widely used, there is not enough definitive research on the effects of occupational exposure to them. And, to date, there is no known safe maximum level of exposure to mAbs. However, the concern around the potential problems from repeated exposure to monoclonal antibodies remains high.
Healthcare professionals could be at risk of dermal, oral, or inhalation exposure during preparation or administration. It is possible that mAbs could lead to allergic and immunogenic reactions8, or reproductive toxicity3 if exposure occurs over time.
According to the Cancer Nurses College2, internal exposure to monoclonal antibodies could potentially pose a risk for:
- toxicity
- genotoxicity
- cytotoxicity
- organ toxicity at low doses
- immunogenicity
- teratogenicity
Some believe the more considerable molecular weight of monoclonal antibodies may prevent dermal absorption. But there is no direct evidence supporting this concept4, and their bigger cell size could make them more challenging to control. Since there are many unknowns about the long-term effects of exposure, safe handling of mAbs is of the utmost importance.