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3 TYPES OF IMMUNOTHERAPIES L20 (ANTIBODY-BASED (Types (Monoclonal…
3 TYPES OF IMMUNOTHERAPIES
L20
CYTOKINE IMMUNOTHERAPY
Cancer treatment
(exogenous administration or cytokines as delivery agents
IL-2
Proleukin
(enhances cell mediated immunity, CTLs, NK cells)
INF-a
PegIntron
(inhibit tumor prolif; :arrow_up:NK & MHC Class 1
G-CSF (Neupogen) & GM-CSF (Leukine)
(hematopoetic growth factors regulate number of myeloid cells [WBC]
Denileukin diftitox (Ontak)
(IL-2 conjugated to diptheria toxin; treat T cell lymphoma)
Non-cancer treatment
(cytokines or soluble cytokine receptors treating immunodef or autoimmune disease)
INF-B
Avonex
(reduces inflammation; treat MS)
INF-gamma
Actimmune
(macrphage activation, :arrow_up:CMI response)
TNF-alpha Blocker
Enbrel
(blocks pro-inflam activity of TNF-a)
CELL-BASED TUMOR THERAPY
Adoptive Cell Transfer
(transfusion of anti-tumor lymphocytes)
using IL-2
LAK Cells
(from peripheral blood)
TIL cells
(from tumor infiltrate)
Dendtritic Cell Therapy
(antigen-stimulated dendtritic cells)
Antigen-stimulated cDCs
present MHC Class I to cT Cells)
ANTIBODY-BASED
Types
Monoclonal antibodies
Polyclonal antibodies
Fragments
Bispecific Antibodies
Naming Convention
(Antibody type/Fab/Fc)
"o"
Murine/Murine/Murine
"xi"
Chimeric/Murine/Human
"zu"
Humanized/95%human/Human
"u"
Human/Human/Human
Antibodies as Drugs
"Naked Antibodies"
Antibodies serving as drugs themselves
mono-, polyclonal, or fragments
Purposes:
Neutralize (good for immune-based disease)
Induce antibody-dep cell-mediated cytotoxicity (ADCC)
Activate compliment
Certolizumab Pegol (Cimzia)
TNF-a
Digoxin immune Fab
(Digibind)
Anti-digoxin; treat overdose
Palivizumab
(Synagis)
Pre-Exposure prevention to resp syncytial virus
Blinatumomab
(Blincyto)
BiTE (bispec Tcell engagers) - CD3 & CD19
Polyclonal, specific immun globin to toxins, venom, Hep B
POST-EXPOSURE prophylaxis
Rho(D)
(RhoGAM)
Initiate phagocytic clearance of fetal RBCs in Rh- moms
Anti-EGRF
:forbidden:EGF, :arrow_down:cell proliferation
Rituximab - Anti-CD20 -B cell cancer
**Can activate:
Complement-mediated cytotoxicity
NK cells
Macrophage phagocytosis or ADCC
Zenapax - Anti-CD25/IL-2
(inhibits proliferation of T cells; imp. transplant rejection)
Yervoy - Anti-CTLA-4
(prevents inhibition of T cells; keep ACTIVE)
Removab - Trifunctional antibodies
CD3 & EpCAM & Fc-gamma recep
T cell, Tumor Cell, Accessory Cell,
"Immunocongugates"
conjugated mMAB or fragments bound to radioactive, toxins, or drugs
Immunotoxins
(Antibody-drug conjugates)
Brentuximab vedotin (Adcetris)
Anti-CD30
(MMAE label; B cell cancers)
Immunoliposomes
(liposome containing cytotoxin + antitumor antibody/fragment)
Anti-Her2 (Doxil)
(Liposome doxorubicin; adv breast cancer)
Radioimmunotherapy
(radioactive nuclide + antitumor antibody/fragment)
Anti-CD20
(radioactive nuclide; breast cancers)
can kill several cells in proximity)
Zevalin (Yttrium 90)
Bexxar (Iodine 131)
Lu-transtuzumab (clinical trial)
ADEPT (antibody dependent enzyme pro-drug therapy)
(enzyme + antitumor antibody/fragment)
Anti-CEA
(enzyme B-lactamase; adenocarcinoma)
HYPOSENSATIZATION (covered later)
VACCINES (later lecture this unit)