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17 Cards in this Set
- Front
- Back
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Objectives include 1) Describe the mechanism of action of CD 20, CD 52, and CD 33 2) Describe common toxicity's associated with mAb therapy for hematologic malignancies 3) Describe recent clinical applications
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4) Describe Immunomodulatory Factors 5) Describe toxicities and recent clinical application
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What is Alemtuzumab?
What is its MOA? |
A monoclonal antibody
It binds to CD 52, which is expressed on T and B cells, tonsil cells, thymocytes, monocytes and macrophages. |
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What is its indication?
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B-cell Chronic Lymphocytic Leukemia in monotherapy
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What are the common toxicities for Alemtuzumab?
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Neutropenia/Lymphopenia and Infection
Needs to be treated prophylactically to prevent infection |
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Clinical Trial
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Alemtuzumab > Chlorambucil in clinical trial of B-cell CLL
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What is Rituximab?
What is its MOA? |
IgG1 antibody like Alemtuzumab, except it is chimeric, not humanized.
It binds to CD20 expressed on B-cells and like most mAb's, mediates CDC and ADCC and apoptosis. |
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What is Rituximab indicated for?
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B-cell Non-hodgkin Lymphoma and CLL.
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What is a unique characteristic of Rituximab?
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It sensitizes the cell to chemotherapy.
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Ritxumiab has many serious adverse effects. One of these is called Tumor Lysis Syndrome. What occurs in Tumor Lysis Syndrome?
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Caused by rapid/massive cancer cell death
Causes hyperuricemia, hyperphosphatemia and hyperkalemia leading to renal failure. |
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What types of cancers predispose you to tumor lysis syndrome and why?
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Hematologic cancers because the cells are already in the blood and when they are lysed, their contents readily flood the circulation.
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Name 3 drugs that utilize mAb's in payload delivery.
Specify what type of toxin is conjugated to these antibodies. |
Gemtuzumab - Immunotoxin conjugated (plant or bacterial toxin)
Ibritumomab Tositumomab - Radioisotope conjugated (forms free radicals in target cells) Not commonly used but available |
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Describe Antibody Directed Enzyme Prodrug Therapy (ADEPT)
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The antibody is linked to a toxin by a linker. The antibody attaches to the cancer cell and is engulfed. The toxin travels to the DNA and damages it.
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Ibritumomab and Tositumomab generally cause cytopenic toxicities. What other toxicity is of particular interest in these agents?
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Secondary Leukemia
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When are immunomodulating agents used?
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When the patient has no other option.
Interferon is used in many cancers after other the failure or intolerance to other agents. Toxicities are abundant and serious with this therapy. Unique side effects include endocrine, thyroid dysfunction, mood disorders and neurologic dysfunction |
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How does IFN work?
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It acts through the IFN receptor which is coupled to a Janus Activated Kinase (JAK) and Tyrosine Kinase (TK). This induces growth inhibition and apoptosis.
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What are the applications of IL therapy?
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Melanoma
Renal Cell Cancer |
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Review Sample
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Questions
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