Intro to Immunotherapy

Question 1

Cancer Immunity

Answer 1

Cancer can express cancer-specific proteins called neoantigens

Question 2

Neoantigens can be targeted by:

Answer 2

T cells

Question 3

What are Neoantigens?

Answer 3

cancer-specific proteins

Question 4

Cancer immunotherapy examples:

Answer 4

1. ) Checkpoint inhibitors
2. ) Adoptive cell transfer
3. ) Therapeutic vaccines

Question 5

What are the ways that cancer “evades” ?

Answer 5

1. ) Escape immune detection

2. ) Suppress anti-tumor responses

Question 6

Escape immune detection

Answer 6

by adopting certain features like loss of cell surface antigens.

Question 7

suppress anti-tumor responses

Answer 7

by activating immune regulatory pathways that inhibit T-cell activity.

Question 8

what’s a checkpoint inhibitor?

Answer 8

Targeted antibodies that reactivate anti-cancer immune responses by releasing the brakes on the immune system.

Question 9

what is a CAR (T cell)?

Answer 9

Chimeric antigen receptor

Question 10

What do they do?

Answer 10

They are T-cells that are re-engineered to express receptors that specifically recognize cancer cells.

Question 11

What are TIL’s?

Answer 11

Tumor-infiltrating lymphocytes

Question 12

What do they do?

Answer 12

cultured to produce large quantities of activated T cells that will re-infiltrate the tumor, recognize the cancer cells and destroy them.

Question 13

What does our immune system do? if working properly?

Answer 13

instructs the body to elicit immune responses to fight pathogens and promote health and well-being.

Question 14

Cancer cells can evade (escape) elimination by:

Answer 14

• escaping immune surveillance mechanisms

- suppressing anti-cancer responses

Question 15

Cancer immunotherapy eliminates cancer indirectly by promoting what?

Answer 15

anti-cancer immune responses (stimulates T cell activation and detection of cancer antigens)

Question 16

What are the 3 types of immunotherapies that stimulate T cell reactivity against cancer?

Answer 16

1) checkpoint inhibitors
2) adoptive T cell transfers
3) cancer vaccines

Question 17

What’s the goal with fighting cancer in the body?

Answer 17

For the T-cell to recognize the antigen

Question 18

What is PD-L1 and PD-1?

Answer 18

Proteins that recognize and bind to each other.

Question 19

What does the PD-L1 inhibitor do?

Answer 19

it makes the T-cell able to recognize the antigen and kill the tumor cell (cancer).

Question 20

How is the presence of PD-L1 determined on the tumor?

Answer 20

Immunohistochemistry. (IHC) looking for proteins on the tumor.

Question 21

Facts about the inhibitors

Answer 21

• checkpoint inhibitor drugs, line of immunotherapy

- multiple inhibitors have FDA approval for a variety of applications

Question 22

What is the most studied and best known PD-1 inhibitor?

Answer 22

pembrolizumab (Keytruda)

Question 23

What are PD-L1 clones?

Answer 23

nearly identical antibodies that come from different cell lines. Different but function the same way.

Question 24

What is the hottest immunotherapy marker right now?

Answer 24

TMB*

Question 25

3 biggest immunotherapy markers

Answer 25

- MSI - TMB - PD-L1

Question 26

Describe what is meant by PD-L1 clone?

Answer 26

almost identical antibodies but slightly different than each other. Because of this, you have to run different immunotherapies.

Question 27

The clinician needs to know which clone they are wanting to oder. True or false?

Answer 27

True

Question 28

Tempus has a default clone that we offer? True or false

Answer 28

True

Question 29

Which immunotherapy metric other than PD-L1 is analyzed at Tempus using IHC?

Answer 29

mismatched repair deficiency

Question 30

Why is tumor mutational burden (TMB) an indicator for immunotherapy?

Answer 30

they make it easier for the immune system to recognize a cancer cell

Question 31

Why is MSI an indicator for immunotherapy ?

Answer 31

they make it easier for the immune system to recognize a cancer cell.

Question 32

More neoantigens produced by tumor=higher chance cancer cells will be recognized and killed by immune cells? true or false?

Answer 32

True

Question 33

Tumor mutational burden

Answer 33

a proxy for neoantigen production

Question 34

Measuring microsatelllite instability

Answer 34

We are trying to see how many error-prone areas are in a cell.

Question 35

Different microsatellite instability

Answer 35

1. ) MSI-H 2. ) MSS 3. ) MSE

Question 36

Microsatellite Instability- High (MSI-H)

Answer 36

a number of microsatellites in tumor cells is significantly different than the number of repeats in the DNA of a normal cell.

Question 37

Microsatellite Stable (MSS)

Answer 37

number of microsatellites in tumor cells is not significantly different than the number of repeats in the DNA of a normal cell.

Question 38

Microsatellite Equivocal (MSE)

Answer 38

tumor cannot be classified as either MSI-H or MSS based on test values.