As with most drugs or medications, many nurses know them by their trade names only.  Occasionally, we had to learn the generic names especially after the patent expires. I have been infusing biologic agents, monoclonal antibodies in particular for over 10 years now and learned that monoclonal antibodies have a standard nomenclature scheme developed by the International Nonproprietary Names (INN) Working Group in October 2008.

Here are the elements of the generic names of monoclonal antibodies:

Prefix + Target/disease class infix + Source infix + Stem

• The  prefix – to create a unique name, a distinct, compatible syllable or syllables should be selected as the starting prefix.
• The infix representing the target or disease- the general disease state subclass must be incorporated into the name.  There are approved specific syllables to denote diseases or targets. The choice of infix is determined by the available information regarding initial clinical indications and antibody action
• The infix indicating the source – identification of the “source” of the antibody is an important safety consideration because some products may cause source-specific antibodies to develop in patients.
• The stem used as a suffix – the suffix “-mab” is used for monoclonal antibodies, antibody fragments and radiolabeled antibodies.

Ok, so  good to know..but what’s the point here?

By just looking at the generic names of monoclonal antibodies, nurses can identify what it is, how it’s made, and what it targets. Let’s take a look at a few examples.

Target/Disease infix:  -tu-/-t-  definition:  tumors    Source infix:  -zu-    definition:  humanized
Example: Trastuzumab- humanized monoclonal antibody that interferes with the HER2/neu receptor

Target/Disease infix: -tu-/-t- definition: tumors Source infix: -xi_ definition: chimeric
Example: Cetuximab – chimeric (mouse/human) monoclonal antibody, an epidermal growth factor receptor (EGFR) inhibitor, for treatment of metastatic colorectal cancer and head and neck cancer.

Target/Disease infix:  -li-/-l-   definition:  immunomodulator  Source infix:  -xi-   definition:  chimeric
Example: Infliximab – chimeric (mouse/human) monoclonal antibody that neutralizes TNF for the treatment of Rheumatoid Arthritis, Ankylosing Spondylitis, Psoriatic Arthritis, Crohn’s Disease, Ulcerative Colitis, Fistulizing Crohn’s and Plaque Psoriasis.

Target/Disease infix: -li-/-l-  definition: immunomodulator   Source  infix:  -u-  definition:  fully human
Example: Adalimumab – fully human monoclonal antibody against TNF for the treatment of  rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, moderate to severe chronic psoriasis and juvenile idiopathic arthritis.

Next time, take a look at your medication’s generic name…can you identify the biologic agent you are about to infuse?

Reference:

American Medical Association: Monoclonal Antibodies – click here