Therapeutic Antibodies for Cancer Part 2

Question 1

Rituximab Type and Target

Answer 1

Chimeric mAb

Specific for CD20 antigen on B cells

Question 2

Rituximab Indication

Answer 2

Non-Hodgkin’s Lymphoma

Question 3

Rituximab Dosing/Administration

Answer 3

 Premedicate before each infusion with acetaminophen and antihistamine

Question 4

Rituximab AE

Answer 4

Tumor Lysis Syndrome
Severe mucocutaneous Reactions
Progressive Multifocal Leukoencephalopathy

Question 5

Ibritumomab Tiuxetan Brand, Type and Target

Answer 5

Zevalin
Murine mAb AIC (antibody isotope complex)
Specific for CD20 on B cells

Question 6

Ibritumomab Indication

Answer 6

B cell NHL

Rituximab refractory follicular NHL

Question 7

Ibritumomab AE

Answer 7

Severe cytopenia
Hematologic toxicity (bone marrow suppression - delayed and takes 2-4 weeks to recover)
Cutaneous and mucocutaneous reactions (fatal)

Question 8

Brentuximab Vedotin Brand, Type and Target

Answer 8

Adcetris
ADC
Specific for CD30 on B cells

Question 9

Brentuximab Indication

Answer 9

Hodgkin’s Lymphoma

Systemic anaplastic large cell lymphoma

Question 10

Brentuximab AE

Answer 10

Liver damage (hepatoxicity)
Bone marrow damage (hematologic)
Reproductive damage (embryo-fetal toxicity)
Tumor Lysis Syndrome

Question 11

Brentuximab Considerations before starting

Answer 11

Very good/normal renal and liver function

Question 12

Ipilimumab MOA

Answer 12

Therapeutic antibody that blocks CTLA-4 to remove T-cell inhibition

Question 13

Nivolumab and Pembrolizumab MOA

Answer 13

Therapeutic antibodies that block PD-1 to remove T-cell inhibition

Question 14

CTLA-4 + Ipilimumab

Answer 14

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

Question 15

PD-1 + Nivolumab and Pembrolizumab

Answer 15

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

Question 16

Ipilimumab Brand and Target

Answer 16

Yervoy

CTLA-4

Question 17

Ipilimumab Clinical Indication

Answer 17

Melanoma

Question 18

Ipilimumab AE

Answer 18

ALL ARE IMMUNE MEDIATED
Entercolitis
Hepatitis
Dermatitis
Neuropathies
Endocrinopathies

Question 19

Nivolumab Brand and Target

Answer 19

Opdivo

Binding of PD-1 Ligand

Question 20

Nivolumab Indication

Answer 20

Melanoma

Question 21

Nivolumab AE

Answer 21

ALL ARE IMMUNE MEDIATED
Pneumonitis
Colitis
Hepatitis
Nephritis/renal dysfucntion
Hypothyroidism/hyperthyroidism
Embryo-fetus toxicity

Question 22

Blinatumonomab Brand and Target/MOA

Answer 22

Blincyto

Activates endogenous T cells by connecting CD3 in the t-cell receptor to CD19 on benign and malignant B cells

Question 23

Blinatumonomab Indication

Answer 23

Ph(-) relapsed or refractory B cell lymphoblastic leukemia

Liquid cancers only

Question 24

Blinatumonomab AE

Answer 24

Cytokine Release Syndrome
Neurological toxicity
Infections
Tumor lysis syndrome
Neutropenia and FN