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Since 1997, nine humanized antibodies received the approval of the FDA to be used as drugs for the treatment of various diseases including transplant rejections, metastatic breast and colon cancers, leukaemia, non-Hodgkin lymphomas, allergic conditions or multiple sclerosis. This review describes techniques used to engineer these antibodies and presents the recent evolutions of these techniques : SDRs grafting orabbreviatedCDRs grafting. Based on the illustrative examples of several antibodies, Mylotarg, Herceptin or Xolair, the therapeutic effectiveness of humanized antibodies are underlined and, with the example of Tysabri, the sometimes dramatic adverse effects associated with their clinical use is stressed. In a second part, this review presents some future and realistic avenues to improve the effectiveness of the humanized antibodies, to decrease their immunogenicity and to reduce their cost.

En 2002, il était prévu que les anticorps humanisés deviendraient une classe majeure de médicaments, notamment en cancérologie. Aujourd’hui, huit d’entre eux sont utilisés en clinique et plus de quarante font l’objet d’essais cliniques. Si leurs mécanismes d’action, multiples, sont difficiles à préciser pour un anticorps donné, les observations réalisées chez les milliers de patients déjà traités démontrent clairement leur intérêt clinique. Ils sont cependant d’utilisation délicate, en particulier lorsqu’ils modulent l’activité d’effecteurs de la réponse immune. Au cours des prochaines années, de nouveaux progrès devront être faits pour sélectionner les cibles pertinentes de ces anticorps, diminuer leur immunogénicité et réduire leur coût., Since 1997, nine humanized antibodies received the approval of the FDA to be used as drugs for the treatment of various diseases including transplant rejections, metastatic breast and colon cancers, leukaemia, non-Hodgkin lymphomas, allergic conditions or multiple sclerosis. This review describes techniques used to engineer these antibodies and presents the recent evolutions of these techniques : SDRs grafting or « abbreviated » CDRs grafting. Based on the illustrative examples of several antibodies, Mylotarg®, Herceptin® or Xolair®, the therapeutic effectiveness of humanized antibodies are underlined and, with the example of Tysabri®, the sometimes dramatic adverse effects associated with their clinical use is stressed. In a second part, this review presents some future and realistic avenues to improve the effectiveness of the humanized antibodies, to decrease their immunogenicity and to reduce their cost.