Immunotherapy

Question 1

Types of active immunotherapy

Answer 1

• Nonspecific
• specific
• indirect

Question 2

Types of passive immunotherapy

Answer 2

• antibodies

- cells

Question 3

-o

Answer 3

mouse

Question 4

-xi

Answer 4

chimeric

Question 5

-zu

Answer 5

humanized

Question 6

-u

Answer 6

human

Question 7

Unconjugated mab

Answer 7

naked antibodies

Question 8

immunoconjugates

Answer 8

linked to something else & deliver payload

1. drug (antibody drug complex)
2. radioactive (radioimmunoconjugate)
3. toxin (immunotoxin)

Question 9

Advantage of immunoconjugates vs unconjugated

Answer 9

• could kill more than just the cell itself, but could lead to collateral damage
• more reliable cell killing

Question 10

unconjugated mab MOA

Answer 10

target antigens on cell surface and induce death through:

1. classic (ADCC, complement)
2. block target)

Question 11

immunoconjugates MOA

Answer 11

Deliver payload to cell targeted by the antibody

Payload internalized and kills cells through traditional MOA

Question 12

Rituximab target

Answer 12

B lymphocyte antigen

Question 13

Trastuzumab target

Answer 13

Target HER-2

-AB drug complex

Question 14

Cetuximab target

Answer 14

Target growth factor receptors and ligands

- bind EGFR and inhibits VEGF production, induce apoptosis

Question 15

Bevacizumab target

Answer 15

VEGF inhibitor

Question 16

INF mechanism

Answer 16

interfere with ability of normal virus to infect cells

3 families (alpha, beta, gamma)

Question 17

Pegylation advantages

Answer 17

1. extend circulating life
2. lower toxicity
3. increased drug stability
4. enhanced drug solubility

Question 18

INF-a adverse effects

Answer 18

flu-like symptoms
rashes, GI
mild myelosuppression
neurologic symtpoms (somnolence, confusion, depression)

Question 19

Interleukin-2

Answer 19

cytokine produced by t-lymphocytes

- increases t cell and NK cell proliferation and cytotoxicity

Question 20

Serious effects of interleukin-2

Answer 20

capillary leak syndrome - requires ICU support

Question 21

Immune checkpoint purpose

Answer 21

• maintain self-tolerance

- protect normal tissue from damage during infection

Question 22

Immune checkpoints

Answer 22

CTLA-4 (acts early as initial response with DC)

PD1 (occurs later)

Question 23

Normal checkpoints

Answer 23

1. signal I: MHC
2. signal II: co-stim; CTLA4 binds B7 and blocks 2n signal
3. inhibits immune response

Question 24

CTLA-4 inhibitors

Answer 24

1. binds to CTLA-4 and prevents immune checkpoint

2. full immune response

Question 25

Ipilimumab

Answer 25

Immune checkpoint inhibitor | - immune response is not specific; can cause collateral damage

Question 26

PD-1/PD-L1 Inhibitors

Answer 26

* primarily for solid tumors - suppresses signal I and frees up for immune response to occur - predicative biomarker

Question 27

Who would most benefit from PD1 inhibitors?

Answer 27

- high mutational burden caused by tobacco or UV exposure | - solid tumors

Question 28

Examples of PD1 inhibitors

Answer 28

- pembrolizumab - nivolumab - cemiplimab

Question 29

Examples of PD-L1 inhibitors

Answer 29

- Atezolizumab - durvalumab - avelumab

Question 30

Which drug has the #2 drug sales worldwide?

Answer 30

Pembrolizumab | PD-1 inhibitor

Question 31

How does cellular therapy work?

Answer 31

- take cells from tumor - growth them - put back into the patient - attack cancer

Question 32

Immune related adverse events (irAEs)

Answer 32

unleash immune response = collateral damage

Question 33

CART therapy

Answer 33

chimieric antigen! - genetically modified T cells - grow cells - give back to patient * *intended for 1 time use**

Question 34

Cytokine-release syndrome (CRS)

Answer 34

most serious ADE of CART capillary leak syndrome *can treat with IL6 receptor target

Question 35

Immunotherapy overall response

Answer 35

induce a few, highly durable tumor responses