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Monoclonal Antibodies

 
 
 
Immunotherapy
Haematologic Malignancies
Solid Organ Malignancies
Other
 
 

Anti-PD-1 Antibodies

 
 
  •  
    IV infusion
    Nivolumab
    Opdivo 
  •  
    IV infusion
    Pembrolizumab
    Keytruda 
    • Mechanism of Action
    • Monoclonal antibodies directed against programmed cell death protein 1 (PD-1), a surface co-inhibitory receptor on circulating activated T cells, B cells and NK cells.
    • PD-1 binds to two ligands (PD-L1 and PD-L2) and inhibit T cell receptor signalling, downregulating immune responses and promoting tolerance.
    • Many tumours express or overexpress PD-L1.
    • Binding of anti-PD1 monoclonal antibodies to PD-1 leaves the ligand unable to bind, and therefore stimulates an ongoing immune response.

Clinical Use

    • Indications
    • Certain solid organ and haematologic malignancies with high levels of microsatellite instability (MSI). Malignancies of particular interest are melanoma, non-small cell lung cancer, renal cancer and bladder cancer, though this is a rapidly growing field.
    • Adverse Effects
    • Immune-Related
    • Endocrinopathies - thyroiditis, adrenalitis, hypophysitis, diabetes mellitus
    • Pulmonary toxicity - pneumonitis
    • Hepatotoxicity - hepatitis, LFT derangement
    • GI toxicity - colitis
    • Rheumatological - flares of previous disease, PMR, arthralgias / myalgias
    • Skin - maculopapular rash, Stevens-Johnson syndrome, Sweet syndrome
    • Other
    • Fatigue
    • Anorexia
    • Headache
    • Dizziness
    • Peripheral neuropathy
    • Nausea / vomiting / diarrhoea
    • Neutropaenia
    • Infections (particularly upper respiratory tract infection)
 
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