22. Immunotherapy Flashcards
What is immunotherapy?
Harnessing the bodies immune system fro a specific manipulation of effects e.g. to specifically fight cancer cells as oppose to chemo which fights specific cells
What is IVIg?
Plasma derived IgG is a key biologic for replacement therapy in primary and secondary immunodeficiency disorder
Also used for some autoimmune disorders
Polyclonal IgG preparation usually given intravenously IVIg but can also be applied subcut
very high dose (1-3KG)
Pooled from several thousand donors
What are the two types of immunotherapy?
Direct (targeted)- antibodies to detect an antigen on the tumour cell and destroy the cell
Indirect- immue system is activated rendering it able to seek and destroy tumour cells
Give some examples of direct types of immunotherapy?
Monoclonal antibodies
Chimeric antigen receptors
Bi-specific antibodies
Give some examples of the indirect immunotherapies
Tumour vaccines Dendritic cell vaccines Adoptive cell transfer Cytokine therapies Checkpoint inhibitor therapies Stimulatory antibodies
What is cytokine therapy?
Immunomodulatory cytokines to active anti tumour immunity
Pegylkated IFN-a, IL-2, GM-CSF
Used in specific cancers
What is rituxin (rituximab)
A monoclonal antibody used as first line treatment for non-hodgkin’s lymphoma
Specific for the CD-20 molecule on the cell surface of a small sub-population of B cells
Also found to be helpful in Ra and SLE
What is infliximab?
An anti-TNF therapy first approved gor RA now used for many autoimmune disease such as ankylosing spondylitis, Crohn’s, UC
Chimeric anitbody that blocks the function of tumour necrosing factor alpha, a pro inflammaotry cytokine
What is herecptin (trastuzumab)
Approved for tretament of HER 2 psotive metastatic breast cacner
What is Skyrizi (risankizumab)
SKYRIZI is an interleukin 23 (IL_23) inhibitor that selectively bloxks IL-23 by binding to its p19 subunit. IL-23 is a cytokine that is involved in inflammatory processes.
What are checkpoint inhibitors?
Antibodies that unlock the gateway to the adaptive immune system
Powerful anti-tumour responses
Potential for immune related adverse effects
What do anti-PD1/PD-L1 antibodies do?
PD-1 Blocks TCR signalling and therefore blocks t cell activation. Therefore Anti PD-1 blocks the PD-1 antibodies
How do immunotheraputic vaccines work?
Take a blood sample from the patient
Culture cells in vitro
Take cytokines that promote APC function
Transfuse patients with APC after uptake of tumour antigen
What is CAR-T cell therapy?
Cells that are engineered to express antigen targeted receptors specific for tumour antigens
