Therapeutic Antibodies for Cancer Part 2 Flashcards
Rituximab Type and Target
Chimeric mAb
Specific for CD20 antigen on B cells
Rituximab Indication
Non-Hodgkin’s Lymphoma
Rituximab Dosing/Administration
Premedicate before each infusion with acetaminophen and antihistamine
Rituximab AE
Tumor Lysis Syndrome
Severe mucocutaneous Reactions
Progressive Multifocal Leukoencephalopathy
Ibritumomab Tiuxetan Brand, Type and Target
Zevalin
Murine mAb AIC (antibody isotope complex)
Specific for CD20 on B cells
Ibritumomab Indication
B cell NHL
Rituximab refractory follicular NHL
Ibritumomab AE
Severe cytopenia
Hematologic toxicity (bone marrow suppression - delayed and takes 2-4 weeks to recover)
Cutaneous and mucocutaneous reactions (fatal)
Brentuximab Vedotin Brand, Type and Target
Adcetris
ADC
Specific for CD30 on B cells
Brentuximab Indication
Hodgkin’s Lymphoma
Systemic anaplastic large cell lymphoma
Brentuximab AE
Liver damage (hepatoxicity)
Bone marrow damage (hematologic)
Reproductive damage (embryo-fetal toxicity)
Tumor Lysis Syndrome
Brentuximab Considerations before starting
Very good/normal renal and liver function
Ipilimumab MOA
Therapeutic antibody that blocks CTLA-4 to remove T-cell inhibition
Nivolumab and Pembrolizumab MOA
Therapeutic antibodies that block PD-1 to remove T-cell inhibition
CTLA-4 + Ipilimumab
T cell receptor and MHC must bind together to activate the T-cell (CD28 to B7)
For inhibition, CTLA-4 binds B7 to prevent activation but ipilimumab comes in and binds CTLA-4 so that CD28 can bind B7 and leads to activation
PD-1 + Nivolumab and Pembrolizumab
PD1 is a receptor that when bound by a ligand creates an inhibitory signal that puts the T-cell to “sleep”
Nivolumab and Pembrolizumab bind PD1 and inhibit the ligand from binding leading to activation for CD28 and B7
Ipilimumab Brand and Target
Yervoy
CTLA-4
Ipilimumab Clinical Indication
Melanoma
Ipilimumab AE
ALL ARE IMMUNE MEDIATED Entercolitis Hepatitis Dermatitis Neuropathies Endocrinopathies
Nivolumab Brand and Target
Opdivo
Binding of PD-1 Ligand
Nivolumab Indication
Melanoma
Nivolumab AE
ALL ARE IMMUNE MEDIATED Pneumonitis Colitis Hepatitis Nephritis/renal dysfucntion Hypothyroidism/hyperthyroidism Embryo-fetus toxicity
Blinatumonomab Brand and Target/MOA
Blincyto
Activates endogenous T cells by connecting CD3 in the t-cell receptor to CD19 on benign and malignant B cells
Blinatumonomab Indication
Ph(-) relapsed or refractory B cell lymphoblastic leukemia
Liquid cancers only
Blinatumonomab AE
Cytokine Release Syndrome Neurological toxicity Infections Tumor lysis syndrome Neutropenia and FN
