Comparison of methods for quantitative analysis of ranibizumab and bevacizumab in human plasma using various bioanalytical techniques, including microfluidic immunoassay, triple quadrupole, and high-resolution liquid chromatography-tandem mass spectrometry approaches

With the ever-growing abundance of complex therapeutic proteins reaching clinical trials and post-marketing, it is vital to develop highly accurate and robust bioanalytical methods for their quantitative analysis in matrices, to support clinical trial data as well as therapeutic drug monitoring. In bioanalysis, proteins have traditionally been evaluated using ligand binding assays (LBAs). However, in recent years, bottom-up LC-MS/MS methods have begun to gain recognition as an alternative to LBAs in situations where either there is a desire to reduce lengthy development times, or where selectivity issues prevent the immunoassay from reaching the desired outcome. In our study, a microfluidic immunoassay was compared to two bottom-up LC-MS/MS methods, including triple quadrupole and high-resolution mass spectrometry methods. The methods were designed to quantitatively analyze a monoclonal antibody, bevacizumab, and its related fab fragment, ranibizumab, in human plasma after intravitreal administration. All three methods were validated (or cross-validated) according to the 2018 Food and Drug Administration (FDA) guidance, and were then compared by quantitating eighteen patient samples on each platform. The concentrations values obtained from each method were compared using percent variability, as well as Bland-Altman and Pearson Correlation plots, to determine agreeability and linear correlation between methods. Based on the results of the validations and comparison studies, all three methods aligned well with each other. However, the LC-MS/MS methods were able to achieve significantly improve sensitivity, with a lower limit of quantitation (LLOQ) of 0.300 ng/mL, compared to 6.00 ng/mL for the LBA, due to the reduction of interferences at lower concentrations using the LC-MS/MS technique (increased selectivity). Therefore, for this specific study, we were able to establish the correlation between methods, while also demonstrating increased value in using LC-MS/MS as an alternative approach to LBAs in bioanalysis.