Week 12 Flashcards
What was the first licensed monoclonal antibody?
Orthoclone OKT3 (muromonab-CD3) which was approved in 1986 for use in preventing kidney transplant rejection
What does most research on monoclonal antibodies focus on?
Identifying new targets for development and maximising their efficacy for use in clinical practice
How many monoclonal antibodies have been approved for use in clinical practice?
30 monoclonal antibodies
What are the major limitations of monoclonal antibodies in clinical practice?
The use of inefficient models for generation, a lack of efficacy and issues of cost-effectiveness
What is the structure and function of an IgG antibody
The IgG antibody is a tetrameric quaternary structure that weighs about 150 KDa. It is a large globular protein that is made up of four peptide chains: two identical heavy chains, gamma (𝞬) and two identical lighter chains. The heavy chain weighs about 50 KDa each and the light chain 25 KDa each
What are humanised antibodies?
Antibodies from non-human species whose protein sequences have been modified to increase their similarity to antibody variants produced naturally in humans
What is the aim of the humanisation of antibodies?
To produce antibody therapeutics that do not elicit an immune response and are safe for human use, without impacting efficacy
What do the mechanisms of action associated with mAbs include?
Direct cell toxicity, immune-mediated cell toxicity, vascular disruption, and modulation of the immune system
What are therapeutic antibodies used for?
They primarily serve to protect the body by attacking cancer cells and cells infected with viruses
Where is the amplification of HER2 observed in?
Approximately 20% of invasive breast carcinomas, and portends a poor prognosis with an increased risk for disease progression and a decreased overall survival
What does HER2 receptor do?
Normally, HER2 receptors help control how a healthy breast cell grows, divides, and repairs itself
What is HER2+ breast cancer?
A breast cancer that tests positive for a protein called human epidermal growth factor receptor 2 (HER2)
How is trastuzumab developed?
Raised murine monoclonal anti- bodies to the extracellular domain of HER-2 and showed that some of these antibodies were capable of inhibiting the growth of cell lines that overexpressed the receptor
What is trastuzumab?
A monoclonal antibody used to treat breast cancer and stomach cancer
What does a positive test for HER2 mean?
Breast cancer may grow quickly and possibly come back
How can resistance to trastuzumab be explained?
By signaling through other HER dimerization
What has been implicated in the resistance to HER2-targeted therapy?
Aberrant activation of the PI3K pathway
What is the newest treatment for breast cancer?
New drugs, known as cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors — which include palbociclib, ribociclib, and abemaciclib — have transformed the standard of cancer treatment by interrupting cancer cell growth, according to an analysis published in 2021 in JCO Oncology Practice
What is trastuzumab-emtansine?
An antibody-drug conjugate consisting of the humanized monoclonal antibody trastuzumab covalently linked to the cytotoxic agent DM1
What are some strategies to overcome resistance of trastuzumab?
Development of antibody-drug conjugates, dual HER2 inhibition strategies, inhibition of PI3K/mTOR pathway and development of modulators of immune checkpoints
What percentage of breast cancers overexpress human epidermal growth factor receptor 2?
Approximately 15-23%
What does the overexpression of HER2 lead to?
The activation of signaling pathways that stimulate cell proliferation and survival
What is T cell checkpoint?
T cells have proteins on them that turn on an immune response and other proteins that turn it off
What are the roles of PD-1 and CTLA4 in inhibiting immune response?
The roles of CTLA-4 and PD-1 in inhibiting immune responses, including antitumor responses, are largely distinct. CTLA-4 is thought to regulate T-cell proliferation early in an immune response, primarily in lymph nodes, whereas PD-1 suppresses T cells later in an immune response, primarily in peripheral tissues
What is the relationship between PD-1 and T cells?
PD-1 inhibits T cell responses
What are the characteristics of PD-1?
PD-1 has one immunoreceptor tyrosine-based inhibitory motif (ITIM) at Y223 and one immunoreceptor tyrosine-based switch motif (ITSM) at Y248. Only ITSM-Y248 is indispensable for PD-1-mediated inhibitory function but how SHP-2 enzymatic activation is mechanistically regulated by one PD-1 phosphotyrosine remains a puzzle
What are the different variations found in cancer immunotherapy?
The checkpoint inhibitors targeting the programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) axis have been validated and are currently used in the clinics
What are therapeutic antibodies often associated with?
Significant side effects and are known to induce immune-related toxicities
How do immune checkpoint inhibitors work?
Blocking checkpoint proteins from binding with their partner proteins
What are the the current first-line systemic therapies for patients with metastatic melanoma?
Anti–PD-1, alone or in combination with anti–CTLA-4, and targeted BRAF therapies
What are antibody based therapies?
Monoclonal antibody drugs are treatments that enlist your body’s germ-fighting immune system against diseases, including cancer
Which drugs are used for the targeted cancer therapies?
Alemtuzumab (certain chronic leukemias)
Trastuzumab (certain breast cancers)
Cetuximab (certain colorectal, lung, head and neck cancers)
How receptor tyrosine kinases act?
As signal transducers that mediate cell-to-cell communication by phosphorylating tyrosine residues on key intracellular substrate proteins
What are the largest class of receptors that activate inherent enzymatic activity?
Receptor Tyrosine Kinases