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Anti-MSLN monoclonal antibodies (mAbs) are a class of targeted biologics designed to bind mesothelin (MSLN), a cell-surface glycoprotein that is highly expressed in various solid tumors, including mesothelioma, pancreatic, ovarian, and lung cancers, while showing limited expression in normal tissues. These antibodies function by binding to the extracellular domain of MSLN, which can lead to the induction of antibody-dependent cellular cytotoxicity (ADCC) and antibody-dependent cellular phagocytosis (ADCP). Additionally, they can block the interaction between MSLN and CA125 (MUC16), a binding event that facilitates tumor cell adhesion and peritoneal metastasis. While several anti-MSLN mAbs, such as amatuximab, have been evaluated in clinical trials, the target is also frequently utilized in the development of more advanced modalities, including antibody-drug conjugates (ADCs), bispecific antibodies, and CAR-T cell therapies.
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