Oncologic Immunotherapies (Wendt) Flashcards
List two HER2-targeting antibodies.
trastuzumab (Herceptin) and pertuzumab (Perjeta)
What antibody is known to bind HER2 and inhibit dimerization/oligomerization?
pertuzumab (Perjeta)
What could be considered a limitation to pertuzumab use?
it cannot be used in patients who have already received prior anti-HER2 therapy or chemotherapy
What drug was involved in the CLEOPATRA trial?
pertuzumab (Perjeta)
What two drugs should pertuzumab be co-administered with?
trastuzumab and docetaxel
List some toxicities associated with trastuzumab.
- flu-like symptoms
- cardiomyopathy/CHF
- hypersensitivity reactions
List two EGFR-targeting antibodies.
cetuximab (Erbitux) and panitumumab (Vectibix)
What is cetuximab indicated for?
colorectal, head and neck cancers
What toxicities are associated with cetuximab?
- severe infusion reaction (usually first dose)
- acneiform rash (positive)
- asthenias
- fever
What is panitumuab indicated for?
colorectal cancer
How often is panitumumab administered?
every 2 weeks
What side effects are associated with panitumumab?
- skin rash
- diarrhea
*no infusion toxicities!!!!!*
Which antibody targets CD20?
ofatumumab (Kesimpta)
What is ofatumumab indicated for?
B-cell non-Hodgkin’s
Which antibody targets VEGF?
bevacizumab (Avastin)
What is bevacizumab indicated for?
metastatic colorectal cancer (+5-FU)
Bevacizumab inhibits solid tumor growth via what effect?
anti-angiogenic effect
List two ADCs.
- ado-trastuzumab-emtansine (Kadcyla)
- brentuximab vedotin (Adcetris)
What is ado-trastuzumab emtansine indicated for?
HER2+ metastatic breast cancer (2nd line)
What toxicities are associated with ado-trastuzumab emtansine?
- normal trastuzumab ones
- thrombocytopenia
- hepatotoxicity
Brentuximab vedotin is an anti-CD30 antibody conjugated to what?
MMAE
What is brentuximab vedotin indicated for?
Hodgkin’s and certain T-cell lymphomas
Reed-Sternberg cells express _______.
CD-30
What drug is an IL-2 analog?
aldesleukin (Proleukin)
What is aldesleukin indicated for?
a lot of shit; very nonspecific
What toxicities are associated with aldesleukin?
- fever
- malaise
- fatigue
- anorexia
Aldesleukin is highly _____________.
pro-inflammatory
What antibody targets CTLA-4?
ipilimumab (Yervoy)
What is ipilimumab indicated for?
advanced metastatic melanoma
What adverse events are associated with Yervoy?
immune-mediated related to inflammatory response (enterocolitis, hepatitis, dermatitis, neuropathy, endocrinopathy)
What antibody may require high-dose corticosteroids for adverse reactions?
ipilimumab
List three PD-1-targeting antibodies.
- pembrolizumab (Keytruda)
- nivolumab (Opdivo)
- cemiplimab (Litayo)
Where is PD-1 expressed?
T-cells
What are PD-1 inhibitors indicated for?
- advanced metastatic melanoma following treatment with ipilimumab and a BRAF inhibitor (if BRAF-V600+)
- NSCLC if PD-L1+
List three PD-L1-targeting antibodies.
- atezolizumab (Tecentriq)
- avelumab (Bavencio)
- durvalumab (Infinzi)
Where is PD-L1 expressed?
tumor cells and macrophages
What are PD-L1 antibody drugs indicated for?
NSCLC in patients with EGFR/ALK mutations that have progressed on those therapies
What exclusions are there for PD-L1 drug use?
- autoimmune disease
- medical conditions requiring immunosuppression
What drug is a bispecific antibody?
blinatumomab (Blincyto)
What does blinatumomab bind?
CD19 and CD3
What is blinatumomab indicated for?
B-cell lymphomas
Is Blincyto a chimeric antibody?
hell nah
With the exception of Provenge, what suffix indicates that a drug is CAR-T?
-leucel
What is isolated from patients in CAR-T therapy?
T-cells
What is CAR-T therapy indicated for?
B-cell/non-Hodgkin’s that hasn’t responded to other therapies
In CAR-T therapy, all _______ are eliminated, but ________ live on indefinitely.
immature B-cells; T-cells
What is isolated from the patient when utilizing sipleucel-T?
monocytes
What is Provenge indicated for?
minimally symptomatic hormone-refractory prostate cancer
What are some side effects of Provenge?
mostly flu-like, increased risk of stroke
What HPV types does Gardasil protect against?
6, 11, 16, 18
What HPV types does Cervarix protect against?
16 and 18
How are HPV vaccines administered?
3 doses over 6 months
What are the major causative agents for cervical cancer?
HPV 16 and 18
