Immunotherapy

Question 1

Substem

Answer 1

Mouse : - O
Chimeric: -xi (half human half mouse)
humanized: -zu (variable domain is mouse but rest of antibody is human)
fully human: -u

Question 2

Trastuzumab

Answer 2

Targets Kinase receptor
Humanized monoclonal antibody specific for HER2
binds to receptor and induces antibody dependent cytotoxicity and induces receptor internalization

can cause an immune response

Question 3

Pertuzumab

Answer 3

Targets Kinase receptor
humanized monoclonal antibody specific for HER2

Binds differently than trastuzumab It inhibits dimerization of the receptor and thus inhibits the kinase activity

Question 4

Cetuximab

Answer 4

Targets Kinase receptor
Chimeric monoclonal antibody that competitively binds to EGFR and blocks kinase activity but also has antibody cytotoxicity
Used for colorectal, head, and neck cancers

rash is common because of EGFR inhibition

Question 5

Panitumumab

Answer 5

Targets Kinase receptor
fully humanized antibody that binds to EGFR and inhibits kinase activity also has cytotoxicity
skin rash but immune response is reduced because its fully humanized

Question 6

Bevacizumab

Answer 6

Targets Kinase receptor
Humanized monoclonal antibody that binds to VEGF and blocks formation of new blood vessels
VEGF is not an oncogene but it is important for the formation of blood vessels and by inhibiting it the cancer cells cannot get vascularization and die
Should not be taken on its own

Question 7

Ramucirumab

Answer 7

Targets Kinase receptor
Fully humanized antibody that binds to the VEGF receptor and blocks the formation of new blood vessels and thus kills the cancer cells

Question 8

Rituximab

Answer 8

Targets B cells
Binds to CD20 and kills lymphoma cells
it will inhibit activity but also cause cytotoxicity and kill the non-hodgkins lymphoma but a downside is it will kill off all healthy B cells in the patient

Question 9

Daratumumab

Answer 9

Targets B cells
binds to CD38 and will cause cytotoxicity that kills off multiple myeloma cancer cells but again this drug will also kill off the natural killer cells (healthy) in the body

Question 10

Ipilimumab

Answer 10

Check point inhibitors
Removed emergency breaks put in place to calm immune system
Recombinant human monoclonal antibody

Binds to CTLA-4 receptor and blocks the receptors inhibitory signaling so the T cells can then go on to kill the cancer cells

Used for metastatic melanoma
You’ll see severe immune-mediated adverse reactions: inflammatory response: dermatitis, neuropathy, endocrinopathy

Question 11

Pembrolizumab

Answer 11

Binds to PD-1 on T cells and blocks its interaction with PDL-1 so its inhibiting the normal inhibition of T cell killing so by blocking the action we are increasing cell death
seen used with ipilimumab and a BRAF inhibitor

Question 12

Atezolizumab

Answer 12

Checkpoint inhibitor
Binds to PDL-1 found on tumor cells and macrophages and blocks the interaction with PD-1 on T cells so this drug is blocking the inhibitory signaling so that the T cells can cause more cell tumor death