Immunotherapy Flashcards
Types of immunotherapy
Cytokines
Tumor or DNA vaccinations
Monoclonal antibodies
- Active or passive.
Checkpoint inhibitions - Inhibition of CTLA-4 or PD-1 in tumors that express these.
Types of tumor antigens
Tumor specific antigens
Tumor associated antigens.
Oncofetal antigens - normally only in fetus
Viral antigens - from viruses
Differentiation antigens - Expressed in other cells but seen in very high amounts in tumor cells.
Unique antigens - Only in tumors. CyclinD/cdk4 multiprotein complex, BCR/ABL
Side effects of immunotherapy
EGFR - skin rashes, interstitial lung disease, hypomagnesemia and hypocalcemia
HER2 - Cardiotoxicity and LF EF reduction
TyrK inhibs - Hand-Foot syndrome and diarrhea
CTLA-4 inhibitors and PDL-1 inhibitors
- T cells are everywhere, so lots of symptoms.
- Worse effects with CTLA-4, but occur in about 60%
- Milder with PDL-1, but occur in about 80%
- Skin rashes, alopecia, psoriasis, vitiligo
- GI upset, diarrhea, colitis, stomatitis
- Pancreatitis, Hepatitis
- Pneumonitis, Pulmonary fibrosis, dyspnoe
- Hypo/Hyperthyroidism
- Hyperglycemia
- CNS Peripheral neuropathy, GBS, Myasthenia gr.
- Renal, interstitial nephritis, AKI
- Uveitis
- Hypertension
- Myalgia, arthritis.