@article{e1c02c146b76438da108c629513276ec,
title = "SARS-CoV-2 variant evasion of monoclonal antibodies based on in vitro studies",
abstract = "Monoclonal antibodies (mAbs) offer a treatment option for individuals with severe COVID-19 and are especially important in high-risk individuals where vaccination is not an option. Given the importance of understanding the evolution of resistance to mAbs by SARS-CoV-2, we reviewed the available in vitro neutralization data for mAbs against live variants and viral constructs containing spike mutations of interest. Unfortunately, evasion of mAb-induced protection is being reported with new SARS-CoV-2 variants. The magnitude of neutralization reduction varied greatly among mAb-variant pairs. For example, sotrovimab retained its neutralization capacity against Omicron BA.1 but showed reduced efficacy against BA.2, BA.4 and BA.5, and BA.2.12.1. At present, only bebtelovimab has been reported to retain its efficacy against all SARS-CoV-2 variants considered here. Resistance to mAb neutralization was dominated by the action of epitope single amino acid substitutions in the spike protein. Although not all observed epitope mutations result in increased mAb evasion, amino acid substitutions at non-epitope positions and combinations of mutations also contribute to evasion of neutralization. This Review highlights the implications for the rational design of viral genomic surveillance and factors to consider for the development of novel mAb therapies.",
author = "MacGregor Cox and Peacock, {Thomas P.} and Harvey, {William T.} and Joseph Hughes and Wright, {Derek W.} and {The COVID-19 Genomics UK (COG-UK) Consortium} and Willett, {Brian J.} and Emma Thomson and Gupta, {Ravindra K.} and Peacock, {Sharon J.} and Robertson, {David L.} and Carabelli, {Alessandro M.} and Smith, {Darren L} and Matthew Bashton and Young, {Gregory R} and McCann, {Clare M} and Andrew Nelson and Matthew Crown and Henderson, {John H} and Amy Hollis and William Stanley and Yew, {Wen C}",
note = "Funding information: The COVID-19 Genomics UK (COG-UK) Consortium is supported by funding from the Medical Research Council (MRC) as part of UK Research & Innovation (UKRI), the National Institute of Health Research (NIHR) (grant code: MC_PC_19027) and Genome Research Limited, operating as the Wellcome Sanger Institute. The authors acknowledge use of data generated through the COVID-19 Genomics Programme funded by the Department of Health and Social Care. The views expressed are those of the author and not necessarily those of the Department of Health and Social Care or the UK Health Security Agency (UKHSA). The authors acknowledge support from the G2P-UK National Virology Consortium (MR/W005611/1) and MRC (MC_UU_12014/12). 'Darren L Smith, Matthew Bashton, Gregory R Young, Clare M McCann, Andrew Nelson, Matthew Crown, John H Henderson, Amy Hollis, William Stanley, Wen C Yew are members of The COVID-19 Genomics UK (COG-UK) Consortium.'",
year = "2023",
month = feb,
day = "1",
doi = "10.1038/s41579-022-00809-7",
language = "English",
volume = "21",
pages = "112--124",
journal = "Nature Reviews Microbiology",
issn = "1740-1526",
publisher = "Nature Publishing Group",
number = "2",
}
