Immunotherapy Flashcards
What would be the first investigation you would undertake in a patient with a personal history of cancer that has a neck swelling ?
USS scan of the neck swelling and biopsy
What percentage of patient with metastatic melanoma have brain metastases?
60%
When metastatic disease is suspected in patients with a personal history of melanoma, what scans would you want to order?
- CT or PET scan to stage the melanoma
2. MRI brain
What does ‘FGD avid’ mean?
FDG is an abbreviation for flurodeoxyglucose.
FDG is able to detect metabolically active tissues
FDG avid tissues consume a lot of glucose and therefore reflects its metabolic activity
Ipilimumab is an immunotherapy drug, which cancers can it be used to treat?
- Advanced melanoma
- Advanced renal cell cancer
- NSCLC
- Pleural mesothelioma
Ipilimumab can be given as an outpatient, what is the IV infusion duration?
90 minutes
How often will an infusion of ipilimumab be given?
Once every 3 weeks
How many infusions of ipilimumab can be given to one patient?
4 treatments
Nivolumab is an immunotherapy, what cancers can it be used to treat?
- Melanoma
- NSCLC
- Renal cancer
- Classical Hodgkin Lymphoma
- Some head and neck cancers
How long can a nivolumab infusion be given over?
30-60 minutes, depending on dose
How often will a cancer patient receive nivolumab treatments?
Once fortnightly or once every 4 weeks (all dependent on dose)
What can happen if a patient with an autoimmune condition receives immunotherapy?
They can be worsened due to the risk of immune-mediated toxicities when taking an immunotherapy agent.
How are immunotherapy induced immune-mediated toxicities managed?
Corticosteroids
What is the basic principle definition for the following grade of toxicity; 1?
Asymptomatic or mild symptoms
What is the basic principle definition for the following grade of toxicity; 2?
Moderate symptoms limiting age appropriate instrumental ADL
What is the basic principle definition for the following grade of toxicity; 3?
Severe or medically significant but not immediately life-threatening. This grade usually requires hospital admission.
What is the basic principle definition for the following grade of toxicity; 4?
Life-threatening consequences - urgent intervention indicated
What is the basic principle definition for the following grade of toxicity; 5?
Death caused by treatment toxicity
Why should patients receiving immunotherapy treatment be discussed with oncology at the earliest opportunity if the present to the ED?
They often require very different treatment to other cancer treatments
What is the pathology behind chemotherapy diarrhoea?
Chemotherapy causes damage to the rapidly dividing cells, if this happens in the GI tract it can cause malabsorption of fluid and increase GI secretions.
How do you know a medication is a monoclonal antibody?
It will have the suffix -mab
