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Anti-DR5 agonist antibodies are a class of therapeutic monoclonal antibodies designed to target and activate Death Receptor 5 (DR5, also known as TRAIL receptor 2 or TNFRSF10B) on the surface of cancer cells. DR5 is a member of the tumor necrosis factor (TNF) receptor superfamily that, upon binding to its endogenous ligand TRAIL (TNF-related apoptosis-inducing ligand) or an agonistic antibody, triggers the extrinsic apoptotic pathway. This activation leads to the recruitment of the death-inducing signaling complex (DISC), activation of initiator caspases (such as caspase-8 and caspase-10), and subsequent activation of executioner caspases (such as caspase-3 and caspase-7), ultimately resulting in tumor cell death. Unlike TRAIL, which can bind to decoy receptors (DcR1 and DcR2), anti-DR5 agonist antibodies specifically target DR5, potentially offering a more targeted therapeutic approach. Several candidates, including conatumumab, tigatuzumab, lexatumumab, drozitumab, ozekibart, and aplitabart, have been evaluated in clinical trials for various solid tumors and hematological malignancies, often in combination with chemotherapy or other targeted agents to overcome resistance.
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