Biologic Agents and Signaling Inhibitors

Therapeutics derived from biologic molecules have transformed many areas of medicine. The development of these new agents is a major shift from previous, largely empirical, approaches to drug development. Biologics, including monoclonal antibodies, recombinant and fusion proteins, and engineered cells, are designed to target pathways involved in disease pathogenesis from cancer and autoimmunity to cardiovascular, neurologic, and infectious disease. In recent years, small molecule inhibitors of intracellular signaling pathways have been added to the list of available targeted therapeutics. Many of these drugs also have been shown in rigorous clinical trials to have efficacy and safety in the treatment of a wide range of conditions ranging from malignancies to autoimmune diseases. This chapter will discuss specific agents in these broad categories, focusing on approved treatments and using selected examples to illustrate molecular targets, mechanisms, and clinical applications. This is a fast-moving area with great potential for even wider clinical applications in the future.