Cited by 109Alzheimer's disease research and treatmentsDementia and Cognitive Impairment ResearchCholinesterase and Neurodegenerative Diseases

Gantenerumab: An anti-amyloid monoclonal antibody with potential disease-modifying effects in early Alzheimer’s disease

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Bateman, Randall J., Cummings, Jeffrey, Schobel, Scott, Salloway, Stephen, Vellas, Bruno, Boada, Mercè, Black, Sandra E., Blennow, Kaj +5 more·2022·Alzheimer's Research & Therapy

Abstract

BACKGROUND: This review describes the research and development process of gantenerumab, a fully human anti-amyloid monoclonal antibody in development to treat early symptomatic and asymptomatic Alzheimer's disease (AD). Anti-amyloid monoclonal antibodies can substantially reverse amyloid plaque pathology and may modify the course of the disease by slowing or stopping its clinical progression. Several molecules targeting amyloid have failed in clinical development due to drug-related factors (e.g., treatment-limiting adverse events, low potency, poor brain penetration), study design/methodological issues (e.g., disease stage, lack of AD pathology confirmation), and other factors. The US Food and Drug Administration's approval of aducanumab, an anti-amyloid monoclonal antibody as the first potential disease-modifying therapy for AD, signaled the value of more than 20 years of drug development, adding to the available therapies the first nominal success since cholinesterase inhibitors and memantine were approved. BODY: Here, we review over 2 decades of gantenerumab development in the context of scientific discoveries in the broader AD field. Key learnings from the field were incorporated into the gantenerumab phase 3 program, including confirmed amyloid positivity as an entry criterion, an enriched clinical trial population to ensure measurable clinical decline, data-driven exposure-response models to inform a safe and efficacious dosing regimen, and the use of several blood-based biomarkers. Subcutaneous formulation for more pragmatic implementation was prioritized as a key feature from the beginning of the gantenerumab development program. CONCLUSION: The results from the gantenerumab phase 3 programs are expected by the end of 2022 and will add critical information to the collective knowledge on the search for effective AD treatments.

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  • Gantenerumab can disassemble and degrade amyloid plaques by recruiting microglia and activating phagocytosis.

    “This antibody can disassemble and degrade amyloid plaques by recruiting microglia and activating phagocytosis [71,72].”

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  1. [8]Bateman RJ Smith J Fox NC Black SE Shij Turner RS The clinical development history of gantenerumab, a subcutaneous anti-Aβ monoclonal antibody for early Alzheimer’s disease: building on lessons from the past and paving a path for the future 2022 San Diego Presented at: Alzheimer’s Association International Conference Annual Meeting

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Authors
Bateman, R. J., Cummings, J., Schobel, S., Salloway, S., Vellas, B., Boada, M., Black, S. E., Blennow, K., Fontoura, P., Klein, G., Assunção, S. S., Smith, J., & Doody, R. S.
Affiliations
  • Washington University in St. Louis (US)
  • University of Nevada, Las Vegas (US)
  • F. Hoffmann-La Roche AG (CH)
  • Brown University (US)
  • Université Toulouse III - Paul Sabatier (FR)
  • Sunnybrook Health Science Centre (CA)
  • Sahlgrenska University Hospital (SE)
  • Roche (United States) (US)
  • Roche (United Kingdom) (GB)
Corresponding author
Bateman, Randall J.
Venue
Alzheimer's Research & Therapy
Published
2022-11-29
Volume
14
Issue
1
Pages
178-178
ISSN
1758-9193 (ISSN-L)
OpenAlex
W4310985942
Cited by
109
References
39
Citations by year
2026: 20 · 2025: 19 · 2024: 40 · 2023: 29 · 2021: 1
FWCI
3.03
Type
journal article
Language
en
Open access
Locations
  • Alzheimer s Research & Therapy (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, cc-by)
  • Digital Commons@Becker (Washington University School of Medicine) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Alzheimer's Association
  • F. Hoffmann-La Roche
  • Genentech
  • National Institute on Aging (R21AG067559, R01AG053798, P20AG068053, U01AG042791, U19AG032438, R01AG046179, RF1AG061900, R01AG053267, U01AG059798, P30AG072959, R35AG071476, R01AG068319)
  • National Institute of General Medical Sciences (P20GM109025)
  • National Institute of Neurological Disorders and Stroke (R01NS095773, U01NS093334)
Topics
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Pharmacology › Cholinesterase and Neurodegenerative Diseases
Keywords
gantenerumab, Alzheimer's disease, anti-amyloid monoclonal antibodies, amyloid plaques, disease-modifying therapy, aducanumab, amyloid positivity, exposure-response modeling, blood-based biomarkers, subcutaneous formulation, drug development
MeSH terms
Alzheimer Disease, Amyloidosis, Humans, United States, Asymptomatic Diseases, Plaque, Amyloid, Amyloidogenic Proteins, Antibodies, Monoclonal, Humanized

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