PERSONALIZED MEDICINE: Edited by Henry Milgrom and René Maximiliano GómezPrecision medicine in clinical oncology: the journey from IgG antibody to IgEFazekas-Singer, Judita,b,c; Singer, Josefb,d; Jensen-Jarolim, Erikaa,bAuthor Information aThe Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna bInstitute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna cBiomedical Image Facility, Institute for Science and Technology Austria, Klosterneuburg dDepartment for Internal Medicine II, University Clinic Krems, Karl Landsteiner Private University for Health Sciences, Krems an der Donau, Austria Correspondence to Erika Jensen-Jarolim, MD, Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria. Tel: +43 1 40400 51100; e-mail: [email protected] Current Opinion in Allergy and Clinical Immunology: June 2020 - Volume 20 - Issue 3 - p 282-289 doi: 10.1097/ACI.0000000000000637 Buy Metrics Abstract Purpose of review Cancer is one of the leading causes of death and the incidence rates are constantly rising. The heterogeneity of tumors poses a big challenge for the treatment of the disease and natural antibodies additionally affect disease progression. The introduction of engineered mAbs for anticancer immunotherapies has substantially improved progression-free and overall survival of cancer patients, but little efforts have been made to exploit other antibody isotypes than IgG. Recent findings In order to improve these therapies, ‘next-generation antibodies’ were engineered to enhance a specific feature of classical antibodies and form a group of highly effective and precise therapy compounds. Advanced antibody approaches include among others antibody-drug conjugates, glyco-engineered and Fc-engineered antibodies, antibody fragments, radioimmunotherapy compounds, bispecific antibodies and alternative (non-IgG) immunoglobulin classes, especially IgE. Summary The current review describes solutions for the needs of next-generation antibody therapies through different approaches. Careful selection of the best-suited engineering methodology is a key factor in developing personalized, more specific and more efficient mAbs against cancer to improve the outcomes of cancer patients. We highlight here the large evidence of IgE exploiting a highly cytotoxic effector arm as potential next-generation anticancer immunotherapy. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.