The monoclonal antibody combination REGEN-COV protects against SARS-CoV-2 mutational escape in preclinical and human studies
Open accessAbstract
Monoclonal antibodies against SARS-CoV-2 are a clinically validated therapeutic option against COVID-19. Because rapidly emerging virus mutants are becoming the next major concern in the fight against the global pandemic, it is imperative that these therapeutic treatments provide coverage against circulating variants and do not contribute to development of treatment-induced emergent resistance. To this end, we investigated the sequence diversity of the spike protein and monitored emergence of virus variants in SARS-COV-2 isolates found in COVID-19 patients treated with the two-antibody combination REGEN-COV, as well as in preclinical in vitro studies using single, dual, or triple antibody combinations, and in hamster in vivo studies using REGEN-COV or single monoclonal antibody treatments. Our study demonstrates that the combination of non-competing antibodies in REGEN-COV provides protection against all current SARS-CoV-2 variants of concern/interest and also protects against emergence of new variants and their potential seeding into the population in a clinical setting.
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The resistance profile of the Gamma variant to the FDA EUA-approved mAbs is similar to that of the Beta variant.
“The resistance profile of the Gamma vari ant to the FDA EUA-approved mAbs is similar to that of the Beta variant 103,109,217,227,228 (TABLe 1).”
From The biological and clinical significance of emerging SARS-CoV-2 variants (2021) · cites this paper as [109]
Of the five FDA EUA-approved mAbs, bamlanivimab, etesevimab and casirivimab are largely inactive against B.1.351 whereas imdevimab and sotrovimab, which bind to the RBD core, retain neutralizing activity.
“Of the five FDA EUA-approved mAbs, bamlanivimab, etesevimab and casirivimab are largely inactive against B.1.351whereas imdevimab and sotrovimab, which bind to the RBD core, retain neutralizing activity 104,109,117,175,204 (TABLe 1).”
From The biological and clinical significance of emerging SARS-CoV-2 variants (2021) · cites this paper as [109]
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“…majority of the currently approved SARS-CoV-2 nAbs and cocktail therapy have been reported to reduce or abrogate neutralizing potency against emerging VOCs, especially for BQ.1.1 and XBB 13,14 . such as LY-CoV1404 15 , REGN10933 +REGN10987 16 , LY-CoV016+LY-CoV555 17,18 , and AZD1061+ AZD8895 19 .”
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- Authors
- Copin, R., Baum, A., Wloga, E., Pascal, K. E., Giordano, S., Fulton, B. O., Zhou, A., Negron, N., Lanza, K., Chan, N., Coppola, A., Chiu, J., Ni, M., Wei, Y., Atwal, G. S., Hernandez, A. R., Saotome, K., Zhou, Y., Franklin, M. C., Hooper, A. T., McCarthy, S., Hamon, S., Hamilton, J. D., Staples, H. M., Alfson, K., Carrion, R., Ali, S., Norton, T., Somersan-Karakaya, S., Sivapalasingam, S., Herman, G. A., Weinreich, D. M., Lipsich, L., Stahl, N., Murphy, A. J., Yancopoulos, G. D., & Kyratsous, C. A.
- Affiliations
- Regeneron (United States) (US)
- Texas Biomedical Research Institute (US)
- Corresponding author
- Kyratsous, Christos A.
- ORCID
- Copin, Richard
- Baum, Alina
- Wloga, Elzbieta
- Pascal, Kristen E.
- Fulton, Benjamin O.
- Zhou, Anbo
- Chiu, Joyce
- Ni, Min
- Wei, Yi
- Atwal, Gurinder S.
- Hernandez, Annabel Romero
- Saotome, Kei
- Zhou, Yi
- Franklin, Matthew C.
- Hooper, Andrea T.
- Hamon, Sara
- Hamilton, Jennifer D.
- Staples, Hilary M.
- Alfson, Kendra
- Carrion, Ricardo
- Norton, Thomas
- Somersan-Karakaya, Selin
- Sivapalasingam, Sumathi
- Herman, Gary A.
- Stahl, Neil
- Murphy, Andrew J.
- Kyratsous, Christos A.
- Venue
- Cell
- Publisher
- Elsevier BV
- Published
- 2021-07
- Volume
- 184
- Issue
- 15
- Pages
- 3949-3961.e11
- ISSN
- 0092-8674 (ISSN-L)
- PMC
- PMC8179113
- OpenAlex
- W3170333570
- Cited by
- 212
- References
- 39
- Citations by year
- 2026: 16 · 2025: 14 · 2024: 24 · 2023: 32 · 2022: 90 · 2021: 36
- FWCI
- 14.40
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Cell (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Cold Spring Harbor Laboratory Institutional Repository (Cold Spring Harbor Laboratory) (acceptedVersion)
- Funders
- Biomedical Advanced Research and Development Authority
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Monoclonal and Polyclonal Antibodies Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- SARS-CoV-2, COVID-19 pandemic, spike protein mutations, variants of concern, antibody combination therapy, hamster model
- MeSH terms
- COVID-19, SARS-CoV-2, Animals, Antibodies, Monoclonal, Chlorocebus aethiops, Cricetinae, Hospitalization, Humans, Lung, Male, Mutation, Neutralization Tests, Vero Cells, Viral Load, Cryoelectron Microscopy
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