Immunotherapy Flashcards

1
Q

What would be the first investigation you would undertake in a patient with a personal history of cancer that has a neck swelling ?

A

USS scan of the neck swelling and biopsy

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2
Q

What percentage of patient with metastatic melanoma have brain metastases?

A

60%

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3
Q

When metastatic disease is suspected in patients with a personal history of melanoma, what scans would you want to order?

A
  1. CT or PET scan to stage the melanoma

2. MRI brain

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4
Q

What does ‘FGD avid’ mean?

A

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

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5
Q

Ipilimumab is an immunotherapy drug, which cancers can it be used to treat?

A
  1. Advanced melanoma
  2. Advanced renal cell cancer
  3. NSCLC
  4. Pleural mesothelioma
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6
Q

Ipilimumab can be given as an outpatient, what is the IV infusion duration?

A

90 minutes

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7
Q

How often will an infusion of ipilimumab be given?

A

Once every 3 weeks

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8
Q

How many infusions of ipilimumab can be given to one patient?

A

4 treatments

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9
Q

Nivolumab is an immunotherapy, what cancers can it be used to treat?

A
  1. Melanoma
  2. NSCLC
  3. Renal cancer
  4. Classical Hodgkin Lymphoma
  5. Some head and neck cancers
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10
Q

How long can a nivolumab infusion be given over?

A

30-60 minutes, depending on dose

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11
Q

How often will a cancer patient receive nivolumab treatments?

A

Once fortnightly or once every 4 weeks (all dependent on dose)

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12
Q

What can happen if a patient with an autoimmune condition receives immunotherapy?

A

They can be worsened due to the risk of immune-mediated toxicities when taking an immunotherapy agent.

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13
Q

How are immunotherapy induced immune-mediated toxicities managed?

A

Corticosteroids

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14
Q

What is the basic principle definition for the following grade of toxicity; 1?

A

Asymptomatic or mild symptoms

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15
Q

What is the basic principle definition for the following grade of toxicity; 2?

A

Moderate symptoms limiting age appropriate instrumental ADL

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16
Q

What is the basic principle definition for the following grade of toxicity; 3?

A

Severe or medically significant but not immediately life-threatening. This grade usually requires hospital admission.

17
Q

What is the basic principle definition for the following grade of toxicity; 4?

A

Life-threatening consequences - urgent intervention indicated

18
Q

What is the basic principle definition for the following grade of toxicity; 5?

A

Death caused by treatment toxicity

19
Q

Why should patients receiving immunotherapy treatment be discussed with oncology at the earliest opportunity if the present to the ED?

A

They often require very different treatment to other cancer treatments

20
Q

What is the pathology behind chemotherapy diarrhoea?

A

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.

21
Q

How do you know a medication is a monoclonal antibody?

A

It will have the suffix -mab