Monoclonal Antibodies Flashcards

Question

Tocilizumab(Actemra) MOA

Answer 1

Inhibit IL-6 *receptors* | —binds to soluble as well as membrane bound interleukin-6 receptors

Answer 2

unseceptible or metastatic melanoma, which no longer responds to other treatments advanced squamous cell carcinoma of head and neck and squamous non-small cell lung cancer (not a cure—just prolongs life) Late stage liver, renal, bladder and colorectal cancer it is used to prolong life The inhibition of PD-1 system produces natural anti-cancer response

Answer 3

Mature B cells go through some final changes to become plasma cells which are the cells that secrete antibodies—Stem cells and Plasma cells do NOT express CD20 When you use a drug that targets CD20 it has a lot of benefits because you are not destroying stem cells and therefore do not require bone marrow transplant and you are not destroying plasma cells so the body will continue to make some antibodies and the patient will not be completely Immunocompromised

Answer 4

Systemic lupus erythematosus

Answer 5

Directed against RSV | prevention of serious lower respiratory infection caused by respiratory syncytial virus (RSV)

Answer 6

IgG1 specific antibody for CD20 receptor contains human constant region and murine heavy and light chains variable regions Fab domain of the antibody binds to CD20 marker on B cells Fc domain recruits immune effector cells and mediators for B cell lysis—lysis can be achieved by antibody-dependent cell mediated cytotoxicity and apoptosis

Answer 7

Chimeric antibody

Answer 8

treatment of head, neck and colorectal cancers and in combination with radiation therapy it is indicated for the treatment of squamous cell carcinoma (locally or regionally advanced). However, it is not given in combination with radiation to patients who did not exhibit a good response to platinum-based therapy (cannot give with KRAS then this will not work) For metastatic colorectal carcinoma expressing EGFR it is administered in combination with irinotecan, provided that the patients are refractory to irinotecan-based chemotherapy

Answer 9

Humanized monoclonal antibody

Answer 10

upper respiratory infection, common cold, HA, and high BP

Answer 11

After binding to the cell surface of the target cell, it is internalized by endocytosis and selectively targets the tumor cells

Answer 12

*GI perforation*, *hemorrhage*, hypertension*, *complications with wound healing*, nephritic syndrome, congestive heart failure and thromboembolic events

Answer 13

binds to alpha subunit of IL-2 *receptors*—prevents the binding of IL-2 to its receptors **Since alpha chain is not expressed on resting T cells, entire immune response may not be suppressed**

Answer 14

Mertansine enters tumor cells, binds to tubulin and kills them and as a result, it kills the cell

Answer 15

Conjugated antibody made up of Trastuzumab linked to cytotoxic agent Mertansine

Answer 16

neutralizes membrane-bound and soluble human TNFα in a dose-dependent manner. Most potent antibody against TNF alpha b/c it is only a fragment and can reach the tissue It has a high affinity for TNF-α but does NOT induce antibody-dependent cellular cytotoxicity, complement activation, or apoptosis in T cells or macrophages.

Answer 17

Moderate to severe psoriasis in adults

Answer 18

Humanized monoclonal antibody (CDR grafted IgG1)

Answer 19

Inhibits TNF alpha Neutralizes the effects of TNF alpha which includes its effects on IL-1 and IL-6 Reduces infiltration of inflammatory cells into the inflamed areas of joints Suppresses the expression of adhesion molecules. Decreases IL-6 levels. Inhibits acute phase response.

Answer 20

specific for epidermal growth factor receptors (HER1) which are expressed on epithelial tissue as well as on the tumors of the colon, rectum, head and neck Causes inhibition of EGF-mediated signal transduction events including the phosphorylation and activation of various kinases associate with EGFR The inhibition of binding of EGF to its receptors suppresses cell growth and decreases in the production of matrix metalloproteinase and vascular endothelial growth factor (VEGF)

Answer 21

Humanized antibody

Answer 22

Human antibody

Answer 23

colorectal cancer in patients who have not responded well to standard chemotherapy Mutations called KRAS and NRAS and BRAF —If there is a mutation in KRAS or NRAS then this antibody will not work (must test the mutations before giving the drug)

Answer 24

Humanized monoclonal antibody

Answer 25

anemia, thrombocytopenia, neutropenia, *increased risk of infection* (monitor for infection for at least one year), allergic reactions including the bronchospasm and angioedema and GI discomfort There is also some risk of secondary malignancy

Answer 26

composed of a chimeric monoclonal antibody brentuximab, which is specific for CD30 molecules and is attached to an antimitotic agent monomethyl auristatin E

Answer 27

lapatinib or paclitaxel

Answer 28

binds to CTLA-4 (cytotoxic T lymphocyte-associated antigen 4) which is expressed on the surface of helper T cells and transmits inhibitory signals to T cells. It is also found on regulatory T cells CTLA-4 binds to CD80 and CD86 (B7) on antigen presenting cells CTLA-4 regulates T cell responses in fighting disease The antibody blocks the function of CTLA-4, resulting in a sustained immune response that attacks the cancer cells (Immune response will continue without stoping)

Answer 29

100% mouse antibody

Answer 30

fatigue, shortness of breath, lack of appetite, GI symptoms, and musculoskeletal pain

Answer 31

Humanized monoclonal antibody

Answer 32

directed against vascular endothelial growth factor (VEGF) receptors present on endothelial cells VEFG promotes the proliferation of endothelial cells and formation of new blood vessels—inhibit formation of new blood vessels which will inhibit angiogenesis and the tumor dies

Answer 33

Fully human monoclonal antibody (IgG2)

Answer 34

Humanized antibody

Answer 35

100% murine antibody

Answer 36

Specific for patients who are afflicted with HER2-positive metastatic breast cancer, and have been previously treated with Herceptin (NOT first line therapy) patients who have already been treated for metastatic breast cancer or have re-developed tumor within six months of therapy

Answer 37

Chimeric monoclonal antibody

Answer 38

progressive multifocal leukoencephalopathy (PML), which is an opportunistic infection caused by John Cunningham (JC) virus

Answer 39

administered subcutaneously for moderate to severe rheumatoid arthritis and systemic juvenile idiopathic arthritis. could be administered with or without methotrexate

Answer 40

flu-like symptoms, upper respiratory infection, lower respiratory infection, rash, neutropenia and anemia

Answer 41

Chimeric monoclonal antibody (IgG1)

Answer 42

Inhibits IL-17A and IL-17A/F | IL-17 stimulates proliferation and activation of keratinocytes

Answer 43

chronic lymphocytic leukemia which is refractory to fludarabine and Alemtuzumab

Answer 44

Chimeric monoclonal antibody

Answer 45

Inhibits tumor necrosis factor α, and used as an immunosuppressive drug

Answer 46

Tuberculosis

Answer 47

Humanized monoclonal antibody (IgG1)

Answer 48

aggressive metastatic breasts cancer who over express HER-2

Answer 49

anaphylactic reaction, chest tightness, wheezing, light- headedness, itches, and rash

Answer 50

development of ventricular dysfunction and congestive heart failure—left ventricular function must be evaluated in all patients before and during trastuzumab therapy Patients treated with trastuzumab exhibit symptoms of cardiac dysfunction, dyspnea, peripheral edema and reduced ejection fraction. In combination with anthracyclin and cyclophosphamide it exhibits severe cardiomyopathy. It may cause allergic reactions, anaphylaxis and pulmonary events. Chills and fever have also been reported after first infusion.

Answer 51

administered once a month subcutaneously for the treatment of moderate to severe rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and ulcerative colitis(in adults)

Answer 52

Zero, two, and six weeks and then every 8 weeks

Answer 53

binds CD52 receptor which is present on the surface of normal and malignant T cells—It mediates its effects via antibody-dependent lysis of target cells (T cells) after binding to CD52 receptors (also neutralizes T cells) CD52 is not present on erythrocytes (RBC)

Answer 54

Human monoclonal antibody

Answer 55

IgG1 conjugated to a linker—one of the two radiation sources Indium-111 or Yttrium-90 The antibody is directed against CD20 receptor which is not shed from the cell surface and is not internalized after binding to the antibody The antibody is supplied in two vials one containing antibody conjugated to Indium-111 and the other to Yttrium-90. After binding to cells expressing CD20 receptors the antibody delivers radiation which enhances its killing effect and induces apoptosis and the radiation causes further damage to the cells by the formation of the free radicals The B cells recover in about 9 months since CD20 receptor is not expressed on B cell precursors

Answer 56

Humanized antibody (CDR grafted IgG1)

Answer 57

ulcerative colitis and inflammatory disease | Used in patients who do not respond well to anti-TNFα therapies

Answer 58

RA and Chron’s

Answer 59

Inhibits integrin α4β7 (LPAM-1, lymphocyte Peyer’s patch adhesion molecule 1) Inhibiting the function of integrin α4β7 activity causes anti-inflammatory effect

Answer 60

Multiple sclerosis and Chron’s lesions in multiple sclerosis are caused by T lymphocytes passing through the blood-brain barrier through their interaction with the adhesion molecules on endothelial cells (high endothelial venules) By inhibiting the adhesion molecules, we block the migration of cytotoxic and inflammatory cells into the brain or the bowel/GI tract

Answer 61

decrease body’s ability to fight infection and increase the risk of serious or life-threatening infections, including severe bacterial, fungal, and/or viral infections. GI discomfort, intestinal obstruction, diarrhea, upper respiratory infection, urinary tract infection, and arthralgia

Answer 62

binds to TNF alpha and blocks its interaction with p55 and p75 cell surface TNF alpha receptors Modulates biological responses that are induced or regulated by TNF alpha including the changes in the levels of the adhesion molecules Rapidly decreases acute phase proteins, serum cytokines, and metalloproteinase

Answer 63

TNF alpha inhibitors

Answer 64

Chimeric antibody

Answer 65

treat rheumatoid arthritis and Crohn’s Disease and it may alter other immune cells

Answer 66

inhibits B cell activating factor. B-cell (BAFF) also referred to as B-lymphocyte stimulator, is responsible for the development and survival of B cells (inhibit production of antibodies)

Answer 67

specific for CD20 protein—its epitope is distinct from rituximab Inhibits early stage B cell activation and cytotoxic to cells expressing CD20 (ADCC)

Answer 68

binds to IL-2 *receptor* alpha chain (CD-25 antigen) on the surface of activated T lymphocytes (IL-2 receptor *alpha chain* are the high affinity receptors) inhibits IL-2 mediated activation of T cells While in circulation it impairs the response of the immune system to the antigenic challenge

Answer 69

Treat RA and Chron’s disease

Answer 70

CDR grafted antibody

Answer 71

Most side effects are felt after the first treatment—immediate side effects include fever, chills and respiratory symptoms; other infusion reactions include nausea, angioedema, headache, hypertension, puritus, uticaria, rash and vomiting

Answer 72

Inhibits p40 subunit of the IL-12 and IL-23 cytokines. IL-12 is also known as natural killer stimulatory factor or cytotoxic lymphocyte maturation factor. This cytokine is made up of a 40 kDA and a 35 kDA subunit—IL-12 p40 subunit is shared by IL-23. • IL-23 plays an important role in inflammatory response • In conjunction with other cytokines (IL-6, TGFβ) IL-23 stimulates naïve CD4+ T cells to differentiate into TH17 cells and TH22 cells, which are distinct from TH1 and TH2 cells. TH17 cells promote the production of IL-17 which is a pro-inflammatory cytokine that enhances T cell priming and enhance the production of IL-1, IL-6, TNFα, and chemokines

Answer 73

flu like symptoms, infection, pain at the site of injection, nausea, and oropharyngeal pain

Answer 74

Human monoclonal antibody

Answer 75

immunogenecity, electrolyte depletion and infusion reactions

Answer 76

It blocks immune checkpoint (immunologic brake) PD-1 (Programed death-1) (PD-1 receptor is present on T cells and B cells) It blocks the activation of PD-1 receptors through their ligand, PD-L1–Binding of PD-L1 to PD-1 receptors causes the inhibition of T cells PD-1, then allows the immune response to be produced in the closed vicinity of the tumor Immune checkpoint—functions as a negative feedback for immune response (downregulate immune response) Inhibit T cell function in secondary lymphoid organs and enhance the function of regulatory T cells Antibody itself is not treating the disease—it is inhibiting the immune checkpoint to allow the immune response to continue without any inhibition

Answer 77

nausea, diarrhea, fever, hypersensitivity, and infusion-site reactions, increased risk of infection

Answer 78

Human monoclonal antibody

Answer 79

Inhibits PCSK9 which will inhibit degradation of LDL receptors and increase removal of LDL cholesterol from circulation

Answer 80

Humanized antibody

Answer 81

Infection, cough, back pain, nausea, vomiting

Answer 82

Severe asthma and the eosinophilic phenotype (latest onset and very severe) NOT used for an acute asthma attack

Answer 83

Infections, neurologic events and malignancies

Answer 84

Malignant melanoma

Answer 85

Human antibody

Answer 86

second line treatment to reduce LDL cholesterol levels and used in patients who do not respond well to diet, exercise, statins or are intolerant to statins

Answer 87

Humanized (human like) or CDR grafted antibody

Answer 88

Chimeric monoclonal antibody

Answer 89

Flu like symptoms, GI problems, liver dysfunction, pain and swelling

Answer 90

Inhibits IL-5 | IL-5 is responsible for the proliferation, maturation, differentiation, and effector function of eosinophils)

Answer 91

abatacept kineret other TNFα blockers

Answer 92

Binds to human epidermal growth factor type 2 receptor protein (HER-2). HER are transmembrane tyrosine kinase receptors involved in cell growth, differentiation and proliferation of epithelial cells and cytoblasts mutation in the HER-2 receptor causes an increased amount of the growth factor receptor protein on the tumor cell surface which increases proliferation of the cells inhibits the proliferation of tumor cells over expressing HER-2–causes HER-2 receptor down regulation by binding to the receptor and causing endocytosis of some receptors as well as limiting the signal for cell growth. Fc region causes lysis via antibody-dependent cell-mediated cytotoxicity

Answer 93

In combination with a standard chemotherapeutic regimen (5-fuouracil-based) it is used for the treatment of patients with malignant *colon or rectal cancer* Some forms of renal, ovarian, lung, and brain cancers

Answer 94

Non-Hodgkin’s lymphoma. Fifty percent of the patients have responded to the treatment with full or partial remission

Answer 95

multiple sclerosis and tissue transplantation

Monoclonal Antibodies Flashcards

(119 cards)