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PHAR 211 > Immune Checkpoint Inhibitors > Flashcards

Immune Checkpoint Inhibitors Flashcards

1
Q

What are some characteristics of immunotherapy?

A

A type of biological therapy that helps the immune system fight cancer through stimulation

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2
Q

What is an alternate name for CD80?

A

B7-1

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3
Q

What is an alternate name for CD86?

A

B7-2

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4
Q

What are some characteristics of immune checkpoints?

A
  • Regulators of the immune system
  • Preventing indiscriminative attacking of cells by the immune system
  • Essential for self-tolerance
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5
Q

What are some examples of stimulatory immune checkpoint molecules?

A
  • CD28
  • CD80
  • CD86
  • 4-1BB
  • CD40
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6
Q

What are some examples of inhibitory checkpoint molecules?

A
  • CTLA-4
  • PD-1
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7
Q

How can cancer cells take advantage of inhibitory immune checkpoint molecules?

A

Cancer cells can evade immune attacks by stimulating the inhibitory immune checkpoint targets

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8
Q

What is CTLA-4?

A
  • Cytotoxic T-lymphocyte-associated protein 4
  • Upregulated in T cells upon exposure to antigens
  • Inhibitory immune checkpoint (blocking CTLA-4 will stimulate immune system and kill cancer cells)
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9
Q

What is the significance of the PD-1 and PD-L1 interaction?

A

PD-1 (Programmed cell death protein 1)

PD-L1 (Programmed death-ligand 1)

Binding between PD-1 and PD-L1 inhibits immune response

PD-L1 expression on cancer cells helps them escape immune system surveillance

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10
Q

What are some characteristics of Ipilimumab therapy?

A

Target: CTLA-4

Indication: Melanoma and malignant pleural mesothelioma

Better tolerated than chemotherapy (but beneficial in only a small portion of patients)

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11
Q

What are some characteristics of Tremelimumab therapy?

A

Target: CTLA-4

Indication: Hepatocellular carcinoma and Metastatic non-small cell lung cancer

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12
Q

What are some characteristics of Nivolumab therapy?

A

Target: PD-1

Indication:
- Melanoma
- Malignant pleural mesothelioma
- Non-small cell lung cancer
- Advanced renal cell carcinoma
- Hodgkin’s lymphoma

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13
Q

What are some characteristics of Pembrolizumab therapy?

A

Target: PD-1

Indication:
- Melanoma
- Non-small cell lung cancer
- Head and neck squamous cell cancer
- Large B-cell lymphoma

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14
Q

What are some characteristics of Cemiplimab therapy?

A

Target: PD-1

Indicated for metastatic cutaneous squamous cell carcinoma (CSCC)

Limited in use to cold tumours (dense stroma and immunosupressive)

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15
Q

What are some characteristics of Atezolizumab therapy?

A

Target: PD-L1

Indication:
- Locally advanced or Metastatic urothelial carcinoma
- Metastatic non-small cell lung cancer
- Locally advanced or metastatic triple negative breast cancer (worst prognosis)

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16
Q

What are some characteristics of Avelumab therapy?

A

Target: PD-L1

Indication:
- Metastatic Merkel cell carcinoma
- Metastatic non-small cell lung cancer
- Locally advanced or metastatic urothelial carcinoma
- Advanced renal cell carcinoma

17
Q

What are some characteristics of Durvalumab therapy?

A

Target: PD-L1

Indicated for Urothelial carcinoma and non-small cell lung cancer

18
Q

What are some common adverse drug reactions associated with immune checkpoint inhibitors?

A

Rash, diarrhea, and fatigue

19
Q

What are some rare adverse drug reactions associated with immune check point inhibitors?

A

Immune-mediated inflammations, such as pneumonitis, hepatitis, nephritis, and colitis

They are all exposed to the environment or have good blood supply and PD-L1 are more common on these tissues and surfaces

20
Q

What are the two atypical patterns of response to immune checkpoint inhibitors?

A
  • Pseudo-progression
  • Hyper-progression
21
Q

What are some qualities of pseudo-progression pattern of response to immune checkpoint inhibitors?

A

Immunotherapy does not generate a rapid response (initial increase in volume of cancer lesions due to infiltration of tumoural tissues by immune cells)

22
Q

What are some qualities of hyper-progression pattern of response to immune checkpoint inhibitors?

A

Acceleration of tumour growth during imune checpoint inhibition (Tumour adapted to therapy by increasing proliferation, evade detection, and hibernate)

23
Q

What is an example of a new immune checkpoint inhibitor?

A

Relatlimab

Target: Lymphocyte activation gene-3 (LAG-3): an inhibitory receptor overexpressed in exhausted T cells

Used in combo with Nivolumab for Melanoma

24
Q
A

PHAR 211 (18 decks)

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