Oncologic Immunotherapies (Wendt)

Question 1

List two HER2-targeting antibodies.

Answer 1

trastuzumab (Herceptin) and pertuzumab (Perjeta)

Question 2

What antibody is known to bind HER2 and inhibit dimerization/oligomerization?

Answer 2

pertuzumab (Perjeta)

Question 3

What could be considered a limitation to pertuzumab use?

Answer 3

it cannot be used in patients who have already received prior anti-HER2 therapy or chemotherapy

Question 4

What drug was involved in the CLEOPATRA trial?

Answer 4

pertuzumab (Perjeta)

Question 5

What two drugs should pertuzumab be co-administered with?

Answer 5

trastuzumab and docetaxel

Question 6

List some toxicities associated with trastuzumab.

Answer 6

• flu-like symptoms
• cardiomyopathy/CHF
• hypersensitivity reactions

Question 7

List two EGFR-targeting antibodies.

Answer 7

cetuximab (Erbitux) and panitumumab (Vectibix)

Question 8

What is cetuximab indicated for?

Answer 8

colorectal, head and neck cancers

Question 9

What toxicities are associated with cetuximab?

Answer 9

• severe infusion reaction (usually first dose)
• acneiform rash (positive)
• asthenias
• fever

Question 10

What is panitumuab indicated for?

Answer 10

colorectal cancer

Question 11

How often is panitumumab administered?

Answer 11

every 2 weeks

Question 12

What side effects are associated with panitumumab?

Answer 12

• skin rash
• diarrhea

*no infusion toxicities!!!!!*

Question 13

Which antibody targets CD20?

Answer 13

ofatumumab (Kesimpta)

Question 14

What is ofatumumab indicated for?

Answer 14

B-cell non-Hodgkin’s

Question 15

Which antibody targets VEGF?

Answer 15

bevacizumab (Avastin)

Question 16

What is bevacizumab indicated for?

Answer 16

metastatic colorectal cancer (+5-FU)

Question 17

Bevacizumab inhibits solid tumor growth via what effect?

Answer 17

anti-angiogenic effect

Question 18

List two ADCs.

Answer 18

• ado-trastuzumab-emtansine (Kadcyla)
• brentuximab vedotin (Adcetris)

Question 19

What is ado-trastuzumab emtansine indicated for?

Answer 19

HER2+ metastatic breast cancer (2nd line)

Question 20

What toxicities are associated with ado-trastuzumab emtansine?

Answer 20

• normal trastuzumab ones
• thrombocytopenia
• hepatotoxicity

Question 21

Brentuximab vedotin is an anti-CD30 antibody conjugated to what?

Answer 21

MMAE

Question 22

What is brentuximab vedotin indicated for?

Answer 22

Hodgkin’s and certain T-cell lymphomas

Question 23

Reed-Sternberg cells express _______.

Answer 23

CD-30

Question 24

What drug is an IL-2 analog?

Answer 24

aldesleukin (Proleukin)

Question 25

What is aldesleukin indicated for?

Answer 25

a lot of shit; very nonspecific

Question 26

What toxicities are associated with aldesleukin?

Answer 26

* fever * malaise * fatigue * anorexia

Question 27

Aldesleukin is highly \_\_\_\_\_\_\_\_\_\_\_\_\_.

Answer 27

pro-inflammatory

Question 28

What antibody targets CTLA-4?

Answer 28

ipilimumab (*Yervoy*)

Question 29

What is ipilimumab indicated for?

Answer 29

advanced metastatic melanoma

Question 30

What adverse events are associated with *Yervoy*?

Answer 30

immune-mediated related to inflammatory response (enterocolitis, hepatitis, dermatitis, neuropathy, endocrinopathy)

Question 31

What antibody may require high-dose corticosteroids for adverse reactions?

Answer 31

ipilimumab

Question 32

List three PD-1-targeting antibodies.

Answer 32

* pembrolizumab (*Keytruda*) * nivolumab (*Opdivo*) * cemiplimab (*Litayo*)

Question 33

Where is PD-1 expressed?

Answer 33

T-cells

Question 34

What are PD-1 inhibitors indicated for?

Answer 34

* advanced metastatic melanoma following treatment with ipilimumab and a BRAF inhibitor (if BRAF-V600+) * NSCLC if PD-L1+

Question 35

List three PD-L1-targeting antibodies.

Answer 35

* atezolizumab (*Tecentriq*) * avelumab (*Bavencio*) * durvalumab (*Infinzi*)

Question 36

Where is PD-L1 expressed?

Answer 36

tumor cells and macrophages

Question 37

What are PD-L1 antibody drugs indicated for?

Answer 37

NSCLC in patients with EGFR/ALK mutations that have progressed on those therapies

Question 38

What exclusions are there for PD-L1 drug use?

Answer 38

* autoimmune disease * medical conditions requiring immunosuppression

Question 39

What drug is a bispecific antibody?

Answer 39

blinatumomab (*Blincyto*)

Question 40

What does blinatumomab bind?

Answer 40

CD19 and CD3

Question 41

What is blinatumomab indicated for?

Answer 41

B-cell lymphomas

Question 42

Is *Blincyto* a chimeric antibody?

Answer 42

hell nah

Question 43

With the exception of *Provenge*, what suffix indicates that a drug is CAR-T?

Answer 43

-leucel

Question 44

What is isolated from patients in CAR-T therapy?

Answer 44

T-cells

Question 45

What is CAR-T therapy indicated for?

Answer 45

B-cell/non-Hodgkin's that hasn't responded to other therapies

Question 46

In CAR-T therapy, all _______ are eliminated, but ________ live on indefinitely.

Answer 46

immature B-cells; T-cells

Question 47

What is isolated from the patient when utilizing sipleucel-T?

Answer 47

monocytes

Question 48

What is *Provenge* indicated for?

Answer 48

minimally symptomatic hormone-refractory prostate cancer

Question 49

What are some side effects of *Provenge*?

Answer 49

mostly flu-like, increased risk of stroke

Question 50

What HPV types does *Gardasil* protect against?

Answer 50

6, 11, 16, 18

Question 51

What HPV types does *Cervarix* protect against?

Answer 51

16 and 18

Question 52

How are HPV vaccines administered?

Answer 52

3 doses over 6 months

Question 53

What are the major causative agents for cervical cancer?

Answer 53

HPV 16 and 18