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504 (Immunology) > Immunity to tumors 2 > Flashcards

Immunity to tumors 2 Flashcards

1
Q

What suffix is used for monoclonal antibodies

A

-mab

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2
Q

What does rituximab target, how does it cause cell lysis

A

CD-20 (non-Hodgkin’s lymphoma), compliment fixation, antibody dependent cell mediated cytotoxicity, induction of apoptosis

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3
Q

Due to rituximab being a chimeric antibody what are precautions that must be taken prior to infusion

A

premedication, slowly titrate infusion, vigilant surveillance

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4
Q

What viral disease must be screened prior to first dose of rituximab, if present what is given as well

A

Hepatitis B, entecavir

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5
Q

What drug is used for prophylaxis of tumor lysis syndrome due to rituximab

A

Allopurinol

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6
Q

What are actions that should be done if there is a moderate infusion reaction, severe infusion reaction (anaphylaxis)

A

stop infusion, administer corticosteriods and H1/H2 blockers, restart infusion at slower rate/ administer hydration, epinephrine and bronchodilators, rechallenge

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7
Q

What are antibody-drug conjugates comprised of

A

Antibody, linker, cytotoxic agent

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8
Q

What does the linker do in antibody-drug conjugates

A

attaches the cytotoxic agent to the antibody

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9
Q

What does anti-CTLA-4 do

A

Binds to CTLA-4 instead of CTLA-4 binding to B7

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10
Q

What is Ipilimumab

A

monoclonal antibody to CTLA-4

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11
Q

What are dermatological side effects to using Ipilimumab, how often does it happen

A

itcing and rash, 50%

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12
Q

How are dermatological side effects managed for Ipilimumab

A

oral antipruritics, grade 3/4 require topical and/or oral corticosteroids

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13
Q

What gastrointestinal side effects to using Ipilimumab

A

diarrhea, abdominal pain, blood and mucous in stool, ileus

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14
Q

How are gastrointesinal side effects managed for Ipilimumab

A

corticosteroids for proloned grade 2 (less than one week) or any grade 3/4, discontinue for grade 3/4

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15
Q

What is grade 2, grade 3 in colitis and diarrhea

A

Colitis: grade 2- abdominal pain, mucus or blood in stool grade 3- severe abdominal pain
Diarrhea: grade 2- increase of 4-6 stools per day grade 3 increase of seven or more stools

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16
Q

What is grade 4 and grade5 in colitis and diarrhea

A

life-threatening, death

17
Q

What are endocrine side effects in using Ipilimumab

A

fatigue, headache, abnormal thyroid test, hypotension

18
Q

How are endocrine side effects in using Ipilimumab managed

A

withhold treatment, treat hyper or hypothyroidism

19
Q

What are pulmonary side effects in using Ipilimumab

A

shortness of breath, inflammation of walls of aveoli (pneumonitis)

20
Q

How does PD-1/PD-L1 antagonists work

A

inhibit inreactions on T-cell and/or tumor cell

21
Q

T/F: Anti-PD-1 monoclonal antibodies inhibit interactions on tumor cells while Anti-PD-L1 inhibt interactions on T cells

A

False: Anti-PD-1 inhibt T-cell and Anti-PD-L1 inhibit interactions on tumor cells

22
Q

What are the PD-1 antibody medications

A

Nivolumab (Opdivo), Pembrolizumab (Keytruda)

23
Q

What are the PD-L1- antibody medications

A

Atezolizumab (Tecentriq), Avelumab (Bavencio), Durvalumab (Imfinzi)

24
Q

What are features of PD-1/PD-L1 antagonists

A

convienient dosing every 3-4 weeks, monotherapy or combination, no premedications required

25
Q

T/F: Steroids should be avoided when using PD-1/PD-L1 antagonsits

A

True

26
Q

How do bi-specific T cell (BITEs) engagers work, how are they taken

A

Combination of CD-19 single chain antibody connected to Cd-3 antibody via linker connecting T cells to B- cells, given as continous infusion for 28 days then 14 days off treatment

27
Q

What are the adverse reactions to (BITEs)

A

cytokine release syndrome, neurotoxicity

28
Q

What medication is a bi-specific T cell engager

A

Blinatumomab (blincyto)

29
Q

What are some cytokine release syndrome side effecs

A

headache, high fever, hypotension, rash, fatigue, dyspnea

30
Q

What are some cytokines released during cytokine release syndrome

A

IFN-gamma, IL-6, IL-2, IL-8, or IL-10, TNF-alpha

31
Q

What drug is given with grade 3 or 4 cytokine release due to blinatumomab, what does it do

A

Tocolizumab (actemra), IL-6 receptor antagonist that causes a reduction in cytokine and acute phase reactant production

32
Q

How often does neurtoxicty occur in BiTEs therapy, when do symptoms occur, what should be avoided

A

2 out of 3 patients, 8 weeks, refrain from driving

33
Q

What are the premediacations for CAR-T therapy

A

Acetaminophen and Diphenhydramine

34
Q

What are side effects of CAR-T therapy

A

Cytokine release syndrome, neurotoxicity, anaphylaxis,

504 (Immunology) (19 decks)

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