Immunotherapy for cancer

Question 1

holy grail of immunotherapy

Answer 1

get the immune system to engage the cancer

Question 2

what shows complete response in Kidney cancer but is dangerous and only works for

Answer 2

IL-2 for RCC

Question 3

Rituximab

Answer 3

Chimeric antibody vs CD20 (B-cells)
Induces ADCC and complement cytotoxicity
Useful for most B cell malignancies and most auto-immune diseases

Question 4

CTLA-4 significance

Answer 4

Enhancement of anti-tumor immunity

turn off the off switch by blocking inhibitory effects of CTLA-4 – turn on T cells

Question 5

ipilimumab

Answer 5

ab against CTLA-4

very helpful in melanoma

Question 6

side effects drugs acting via CTLA-4 blockade

Answer 6

LOTS of auto-immune phenomena, including colitis, rash, endocrinopathies, pulmonary toxicity and a host of odd-ball, sometimes severe, and sometimes long-lasting side effects.

Question 7

significance of PD-1

Answer 7

binding of PD-1 by ligand blocks TCR signaling and therefore blocks T cell activation
Mab blockade of PD-1 or its ligand allows for T cell activation

Question 8

PD-1 vs CLTA-4

Answer 8

way fewer side effects /AI issues with PD-1 blockers

Question 9

nivolumab

Answer 9

great for lung cancers, not for kidney

Question 10

PD-1/L1 blockade active in

Answer 10

in cancers with Mismatch Repair defects and other mechanisms of high genetic variation

Question 11

toxicities PD-1/L1 blockade

Answer 11

So far, these are MUCH better tolerated than Ipi. Main toxicities are colitis, rash and thyroid problems