Block 2 Immuno Drugs (mostly MAb's)

No anti-inflammatory lecture specific info

Prednisone (short-duration)

Dexamethasone (long duration)

Corticosteroids

MOA: Inhibits transcription of many inflammatory mediators genes

Use:

• Prevention and reversal of acute allograft rejection

• Treatment of nearly all inflammatory conditions, esp. on a short-term basis

Cyclosporine

Tacromilus

Calcineurin inhibitor

No IL2, no T cell activation or proliferation

B cells/Phagocytes are normal, decreasing risk of sepsis

Toxicity: Nephrotoxicity

Potency T > C

Siromilus

mTOR inhibitor

MOA: blocks IL2 mediated B/T cell proliferation

Cyclophosophamide

Cytotoxic drug

MOA: DNA Alkylating

Prevention/reversal of graft rejection

Uses: SLE, Pemphigus

Azathioprine

Cytotoxic drug

MOA: Purine antagonist. Drug → 6-MP → prevents purine conversion

Reversal of acute graft rejection

Uses: RA, IBD

Mycophenolate Mofenil (MFF)

Cytotoxic drug

MOA: MFF → MPA → IMP DHase

Uses:

• prevents GVHD

• Prophylaxis of organ rejection

Basiliximab

Monoclonal Anti-CD25

MOA: competitive inhibitor of IL2 binding

Rituximab

Monoclonal Anti-CD20

Blocks humoral Ab mediated rejection

Brentuximab

Monoclonal Ab Conjugate (Chemolabeled)

Consists of Anti-CD30 Ab + Monomethylauristatin E

Etanercept

Fusion Protein

MOA: TNF-α receptor linked to IgG

Use: RA

Abatacept

Fusion Protein

MOA: CTLA-4 linked to modified human IgG

Use: RA

Omalizumab

Monoclonal Ab

Target: IgE

Use: Asthma

IVIG (IV Immune globulin)

Polyclonal Ab

MOA: down regulates Auto-Ab production

Use: treating autoimmune or inflammatory neuromuscular diseases

Rhogam

Polyclonal Ab

MOA: IgG Anti-D (RH+)

Use: prevent hemolytic disease of the newborn

Rituximab cancer use

Monoclonal Anti-CD20 (Tumor specific)

Use:

• B cell CLL

• NHL

Alemtuzumab

Monoclonal Ab (Tumor specific)

Binds to CD52 on B cells

Use: B cell CLL

Bevacizumab

Monoclonal Ab: Angiogenesis inhibitor

Target: VEGF (vascular endothelial growth factor) by inhibiting it extracellularly

MOA: Neutralization

Trastuzumab

Monoclonal Ab: Growth Signaling inhibitor

Target: HER2

MOA: Apoptosis

Uses:

• Breast Ca

• Metastatic colorectal Ca

• Squamous cell Ca’s

Cetuximab

Monoclonal Ab: Growth Signaling inhibitor

Target: Epidermal Growth Factor Receptor

MOA: Apoptosis

Uses:

• Metastatic colorectal Ca

• Squamous cell Ca’s

Y⁹⁰ Ibritumomab

Radiolabeled MAb Conjugate

Target: CD20

Use: NHL

Brentuximab cancer use

Monoclonal Ab Conjugate (Chemolabeled)

HL

Blinatumomab

Bispecific MAb

MOA: Binds to CD19 (on leukemia or lymphoma cells) and CD3 (T cells)

• mode of action requires neither TCR or MHC, nor co-stimulation

Uses: Relapsed or Refractory B cell ALL

Pembrolizumab

Monoclonal MAb: PD-1 Inhibitor

MOA: prevents T cell from being inhibited

Uses:

• Metastatic melanoma

• 17 other Ca’s

Atezolizumab

Monoclonal MAb: PD-L1 Inhibitor

MOA: inhibits tumor cells PD-L1 from interacting with PD1 on tumor specific CTLs

Use:

• Non-small cell lung Ca

• 3 other Ca’s

Ipilimumab

Monoclonal MAb: CTLA-4 Inhibitor

May result in ADCC-mediated lysis of Treg cells

Uses: Metastatic melanoma

Tisagenlecleucel

CAR-T drug

MOA: Target CD19 on B cells

Approved for the the treatment of pre-B cell ALL

Gardasil-9

Vaccine containing virus-like particles

Prevents HPV-induced cervical cancer

Lecanemab

Monoclonal Ab for Alzheimer’s Disease

Use: early to mild stages of AD

Side effect: brain swelling and tiny brain bleeds