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Purpose: The purpose of this paper is to reflect on the authors' experiences of conducting research with refugees and asylum seekers in Malaysia over multiple research projects in order to identify limitations to current procedures for receiving ethical approval for a study. It argues that the moral complexity of working with marginalized and excluded groups is not reflected in existing approaches. Design/methodology/approach: Ensuring that research is ethical is integral to any empirical study, using any research design. Procedures for ensuring ethics have been developed by professional bodies across many academic fields, predominantly drawing on western legal frameworks and conceptions of agency. However, these procedures may not have applicability to certain cultural, social and political settings. The discussion in this paper focuses on devising ethical approaches for research participants from marginalized and excluded communities in diverse parts of the world, including those with no possibility of legal recourse. Findings: Problems with the use of established procedures for four aspects of ethical research are identified, namely, access and gatekeepers; consent; reciprocity; and confidentiality. Originality/value: The paper develops a framework for continuous ethical reflexivity. It argues that this framework should replace the established procedural approach to ethics, approved by an Institutional Review Board or ethics committee. Instead, the IRB should assign an ethical mentor who is jointly responsible with the researcher for ensuring research ethics through the use of the framework.

Oxidized low-density lipoprotein (LDL) plays an essential role in the pathogenesis of atherosclerosis. The purpose of this study was to characterize the pharmacokinetics (PK) of a human recombinant IgG1 antibody to oxidized LDL (anti-oxLDL) in cynomolgus monkey. The tissue biodistribution of anti-oxLDL was also investigated using positron emission tomography (PET) imaging.Anti-oxLDL was conjugated with the N-hydroxysuccinimide ester of DOTA (1,4,7,10-tetraazacyclododecane 1,4,7,10-tetraacetic acid) and radiolabeled by chelation of radioactive copper-64 ((64)Cu) for detection by PET. Anti-oxLDL was administered as a single intravenous (IV) dose of 10 mg/kg (as a mixture of radiolabeled and non-labeled material) to two male and two female cynomolgus monkeys. Serum samples were collected over 29 days. Two ELISA methods were used to measure serum concentrations of anti-oxLDL; Assay A was a ligand binding assay that measured free anti-oxLDL (unbound and partially bound forms) and Assay B measured total anti-oxLDL. The biodistribution was observed over a 48-hour period following dose administration using PET imaging.Anti-oxLDL serum concentration-time profiles showed a biphasic elimination pattern that could be best described by a two-compartment elimination model. The serum concentrations obtained using the two ELISA methods were comparable. Clearance values ranged from 8 to 17 ml/day/kg, while beta half-life ranged from 8 to 12 days. The initial volume of distribution and volume of distribution at steady state were approximately 55 mL/kg and 150 mL/kg, respectively. PET imaging showed distribution predominantly to the blood pool, visible as the heart and great vessels in the trunk and limbs, plus diffuse signals in the liver, kidney, spleen, and bone marrow.The clearance of anti-oxLDL is slightly higher than typical IgG1 antibodies in cynomolgus monkeys. The biodistribution pattern appears to be consistent with an antibody that has no large, rapid antigen sink outside the blood space.

More than 50 monoclonal antibodies (mAbs), including several antibody-drug conjugates, are in advanced clinical development, forming an important part of the many molecularly targeted anticancer therapeutics currently in development. Drug development is a relatively slow and expensive process, limiting the number of drugs that can be brought into late-stage trials. Development decisions could benefit from quantitative biomarkers, enabling visualization of the tissue distribution of (potentially modified) therapeutic mAbs to confirm effective whole-body target expression, engagement, and modulation and to evaluate heterogeneity across lesions and patients. Such biomarkers may be realized with positron emission tomography imaging of radioactively labeled antibodies, a process called immunoPET. This approach could potentially increase the power and value of early trials by improving patient selection, optimizing dose and schedule, and rationalizing observed drug responses. In this review, we summarize the available literature and the status of clinical trials regarding the potential of immunoPET during early anticancer drug development., (© 2015 by American Society of Clinical Oncology.)