Immunotherapy + T Cell Engaging Treatments

Question 1

What are the pillars of cancer treatment?

Answer 1

Surgery
Radiotherapy
Cytotoxic chemotherapy
Molecular targeted therapy
Immunotherapy

Question 2

Advantages + disadvantages of bispecific antibodies

Answer 2

advantages:
- off the shelf
- access
- favourable toxicity
.
disadvantages:
- dependent on endogenous T cell function
- durability less clear
- long term administration

Question 3

Explain the use of checkpoint inhibitors in cancer treatment

Answer 3

• immune checkpoint on T cells are over expressed in some cancers
• check point inhibitors ‘block the blocker’ > T cell activation + anti tumour immune response

Question 4

Outline the use of chimaeric antigen recpetor T cells in immunotherapy

Answer 4

• treat certain types of cancers e.g. leukaemia + lymphoma
• patient T cells are extracted + modified in lab > chimaeric antigen receptors on surface are produced
• these receptors enable T cells to recognise + target specific proteins on cancer cells when back in patient’s body + attack them

Question 5

What cancers are chimaeric antigen recpetor T cells used to treat?

Answer 5

Leukaemia
Lymphoma

Question 6

Side effects of chimaeric antigen receptor T cells

Answer 6

T cell engaging toxicity/cytokine release syndrome
- it occurs when activated CAR T cells release large amounts of cytokines > excessive immune reaction
- can cause flu like symptoms to severe life threatening complications

Question 7

What causes T cell engaging toxicity/cytokine release syndrome?

Answer 7

It occurs when activated CAR T cells release large amounts of cytokines > excessive immune reaction

Question 8

Tumour intrinsic reasons for T cell engaging therapies fail

Answer 8

• target antigen loss
• lineage switching
• loss of CD58

Question 9

Tumour extrinsic reasons for T cell engaging therapies fail

Answer 9

• limited CAR T cell expansion
• reduced CAR T cell persistence
• T cell exhaustion/dysfunction