Monoclonal Antibodies / Novel Therapy Flashcards
Daratumumab
CD38 (plasma cells)
Multiple myeloma
Bevacizumab
VEGF
Metastatic colon and gynae cancers
Trastuzumab
HER2 receptor
Trade name herceptin
Breast cancer, stomach cancer
Cardiac toxicity
Pembrolizumab
Anti-PD-1 (checkpoint inhibitor)
- Binds to and blocks PD-1 located on lymphocytes
Melanoma, NSCLC, head/neck cancers, stomach cancer, Hodgkin lymphoma
Ipilimumab
Anti-CTLA-4 (cytotoxic T cell lymphocyte associated protein)
Melanoma
In combinations - RCC, HCC, CRC (micro satellite unstable or mismatch repair deficient), NSCLC
Nivolumab
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
Ustekinumab
Anti-p40 subunit IL12/IL23
Psoriasis/psoriatic arthritis, IBD
Natalizumab
Alpha4-integrin (cell adhesion molecule)
MS, Crohns
Tocilizumab
IL-6
RA, systemic juvenile idiopathic arthritis, GCA, cytokines release syndrome
Adalimumab
TNF-Alfa
RA, psorasis/psoriatic arthritis, ankylosis spondylitis, IBD, juvenile idiopathic arthritis
Basiliximab
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
Rituximab
CD20 (B cells)
NHL, CLL, RA, GPA, ITP, Myesthenia
Cetuximab
EGFR inhibitor
Metastatic colorectal, head and neck or NSCLC
Infliximab
TNF Alfa inhibitor
IBD, RA, ank spond, psoriasis, behcets
Eculizumab
Anti-C5
Paroxysmal nocturnal haemoglobinuria
Atypical HUS
Risk of meningococcal infections
Omalizumab
Binds IgE in circulation
Asthma, Anti allergy, allergic rhinitis
Belimumab
Human monoclonal Ab that inhibits BAFF - B-cell activating Factor (BLyS - B-lymphocyte stimulator)
Used in SLE.
Dupilumab
Human Ab - IL4-receptor (alpha subunit)
REceptor antagonist - modulates IL4 and IL13
Uses: atopic dermatitis, asthma
Golimumab
TNF Inhibitor
Baricitinib / Tofacitinib
Oral JAK - Inhibitors
Uses - RA, IBD (Tofacitinib)
Increase risk of shingles and viral infections
Abatecept
CTLA4-Ig fusion protein (mimic)
Acts as decoy - binding CD80/86 on APC
Atezolizumab
PD-L1 inhibitor
Fully humanised against protein PD-L1
PD-L1 can be highly expressed on certain tumours
Certolizumab
Anti-TNF
Safest in pregnancy
Meprolizumab / Benralizumab
Meprolizumab - Mops up IL-5
Benralizumab - Binds to IL-5 receptor
Used in severe T2 high asthma
Side effect : Zoster
Tezepelumab
Anti -TSLP (Thymic Stromal Lymphopoietin)
- An epithelial cytokine involved in initiation and persistence of airway inflammation
- New agent in Asthma
Canakinumab
Anti-IL-1beta
Uses: JIA, AOSD, Periodic Fever Syndromes
Secukinumab
Anti-IL-17A
Uses: Psoriasis, Ank Spons, PsA
Anakinra
IL-1R antagonist protein
Uses: RA, Still’s Disease, Periodic Fever Syndromes,
Offlabel - Gout, CPPD
Obinutuzumab
Anti-CD20
CLL - In combination with Chlorambucil (PO)
Risk: Hep B reactivation and PML
Ocrelizumab
Anti-CD20
Uses: MS
Including PPMS
Alemtuzumab
Anti-CD52
Uses: MS and CLL
Risks: Thryoiditis 30%, AIHA, ITP
Denosumab
Binds RANK-L
Works like OPG
Romosozumab
Sclerostin Antibody -
Normally: Scleorstin negative regulator of bone formation
- Thus romosozumab binds scleostin and its unable to bind onto LRP5 receptor
Guselkumab
Anti-IL23 targeted against p19 unit
Use: PsA
Anifrolumab
Anti-Type 1 Interferon Receptor Subunit 1
SLE - Reduces time to first flare
Vedolizumab
Anti alpha4, Beta7 integrin (on T cell surface)
Uses: IBD (both UC and CD), Superior to adalimumab
Evolocumab
PCSK9 Inhibitor
Tezepelumab
Anti-TSLP
Anti-alarmin (Innate immune system)
Use: Asthma - Improves FEV1
Emicizumab
Bispecific antibody - Factor IXa and factor X
Bezlotoxumab
Bind and neutralize C. difficile toxins A and B,
