Monoclonal Antibodies / Novel Therapy

Question 1

Daratumumab

Answer 1

CD38 (plasma cells)

Multiple myeloma

Question 2

Bevacizumab

Answer 2

VEGF

Metastatic colon and gynae cancers

Question 3

Trastuzumab

Answer 3

HER2 receptor
Trade name herceptin
Breast cancer, stomach cancer

Cardiac toxicity

Question 4

Pembrolizumab

Answer 4

Anti-PD-1 (checkpoint inhibitor)
- Binds to and blocks PD-1 located on lymphocytes
Melanoma, NSCLC, head/neck cancers, stomach cancer, Hodgkin lymphoma

Question 5

Ipilimumab

Answer 5

Anti-CTLA-4 (cytotoxic T cell lymphocyte associated protein)
Melanoma
In combinations - RCC, HCC, CRC (micro satellite unstable or mismatch repair deficient), NSCLC

Question 6

Nivolumab

Answer 6

Anti PD-1 inhibitor (programmed death, present on all activated T cells, inhibited by PD-L1 and PD-L2 from cancer cells)
Melanoma (first line with ipilimumab if no BRAF mutation)
Also NSCLC, RCC, urothelial carcinoma

Question 7

Ustekinumab

Answer 7

Anti-p40 subunit IL12/IL23

Psoriasis/psoriatic arthritis, IBD

Question 8

Natalizumab

Answer 8

Alpha4-integrin (cell adhesion molecule)

MS, Crohns

Question 9

Tocilizumab

Answer 9

IL-6

RA, systemic juvenile idiopathic arthritis, GCA, cytokines release syndrome

Question 10

Adalimumab

Answer 10

TNF-Alfa

RA, psorasis/psoriatic arthritis, ankylosis spondylitis, IBD, juvenile idiopathic arthritis

Question 11

Basiliximab

Answer 11

IL-2 (T cells), CD25
- Basiliximab competes with IL-2 to bind to IL-2 receptor on T cell and thus prevents IL-2 from binding and signally
Renal transplant induction

Question 12

Rituximab

Answer 12

CD20 (B cells)

NHL, CLL, RA, GPA, ITP, Myesthenia

Question 13

Cetuximab

Answer 13

EGFR inhibitor

Metastatic colorectal, head and neck or NSCLC

Question 14

Infliximab

Answer 14

TNF Alfa inhibitor

IBD, RA, ank spond, psoriasis, behcets

Question 14

Eculizumab

Answer 14

Anti-C5

Paroxysmal nocturnal haemoglobinuria
Atypical HUS
Risk of meningococcal infections

Question 15

Omalizumab

Answer 15

Binds IgE in circulation

Asthma, Anti allergy, allergic rhinitis

Question 16

Belimumab

Answer 16

Human monoclonal Ab that inhibits BAFF - B-cell activating Factor (BLyS - B-lymphocyte stimulator)
Used in SLE.

Question 17

Dupilumab

Answer 17

Human Ab - IL4-receptor (alpha subunit)
REceptor antagonist - modulates IL4 and IL13
Uses: atopic dermatitis, asthma

Question 17

Golimumab

Answer 17

TNF Inhibitor

Question 18

Baricitinib / Tofacitinib

Answer 18

Oral JAK - Inhibitors
Uses - RA, IBD (Tofacitinib)
Increase risk of shingles and viral infections

Question 19

Abatecept

Answer 19

CTLA4-Ig fusion protein (mimic)

Acts as decoy - binding CD80/86 on APC

Question 20

Atezolizumab

Answer 20

PD-L1 inhibitor
Fully humanised against protein PD-L1
PD-L1 can be highly expressed on certain tumours

Question 21

Certolizumab

Answer 21

Anti-TNF

Safest in pregnancy

Question 22

Meprolizumab / Benralizumab

Answer 22

Meprolizumab - Mops up IL-5
Benralizumab - Binds to IL-5 receptor

Used in severe T2 high asthma
Side effect : Zoster

Question 23

Tezepelumab

Answer 23

Anti -TSLP (Thymic Stromal Lymphopoietin)

• An epithelial cytokine involved in initiation and persistence of airway inflammation
• New agent in Asthma

Question 24

Canakinumab

Answer 24

Anti-IL-1beta

Uses: JIA, AOSD, Periodic Fever Syndromes

Question 25

Secukinumab

Answer 25

Anti-IL-17A

Uses: Psoriasis, Ank Spons, PsA

Question 26

Anakinra

Answer 26

IL-1R antagonist protein
Uses: RA, Still’s Disease, Periodic Fever Syndromes,
Offlabel - Gout, CPPD

Question 27

Obinutuzumab

Answer 27

Anti-CD20
CLL - In combination with Chlorambucil (PO)
Risk: Hep B reactivation and PML

Question 28

Ocrelizumab

Answer 28

Anti-CD20
Uses: MS
Including PPMS

Question 29

Alemtuzumab

Answer 29

Anti-CD52
Uses: MS and CLL
Risks: Thryoiditis 30%, AIHA, ITP

Question 30

Denosumab

Answer 30

Binds RANK-L

Works like OPG

Question 31

Romosozumab

Answer 31

Sclerostin Antibody -
Normally: Scleorstin negative regulator of bone formation
- Thus romosozumab binds scleostin and its unable to bind onto LRP5 receptor

Question 32

Guselkumab

Answer 32

Anti-IL23 targeted against p19 unit

Use: PsA

Question 33

Anifrolumab

Answer 33

Anti-Type 1 Interferon Receptor Subunit 1

SLE - Reduces time to first flare

Question 34

Vedolizumab

Answer 34

Anti alpha4, Beta7 integrin (on T cell surface)

Uses: IBD (both UC and CD), Superior to adalimumab

Question 35

Evolocumab

Answer 35

PCSK9 Inhibitor

Question 36

Tezepelumab

Answer 36

Anti-TSLP
Anti-alarmin (Innate immune system)
Use: Asthma - Improves FEV1

Question 37

Emicizumab

Answer 37

Bispecific antibody - Factor IXa and factor X

Question 38

Bezlotoxumab

Answer 38

Bind and neutralize C. difficile toxins A and B,