Jared: Monoclonals and Cellular Therapies

What antibodies are used against leukemias and lymphomas that express CD20?

Rituximan, Obinutuzumab, Ofatumumab

What long term medication(s) would you expect to expect to find administered to a patient who is/has received Rituximab?

What pre-medications should be administered to a patient who is to receive Rituximab?

Acetaminophen, Diphenhydramine

Why do patients who are to receive Daratumumab usually get type & crossed for blood transfusions before starting the drug?

What is the extracellular target of Brentuximab Vendotin, and in what way is the antineoplastic effect of this drug different than that of Rituximab?

CD30

What is the extracellular target of Gemtuzumab Ozogamicin, and in what way is the antineoplastic effect of this drug different than that of Rituximab?

CD33

What are the extracellular targets of Blinatumomab, and in what way is the antineoplastic effect of this drug different the ADCs?

Binds to CD19 expressed on B cells and CD3 expressed in T cells creating cytolytic synapse

What are the two most worrisome adverse effects of Blinatumomab?

1. Life threatening CRS (Cytokine release syndrome)

2. Neurotoxicity ?

What is the common target of all of the Bispecific T-cell Engager drugs discussed in this lecture?

CD3 on T cells

What is a common toxicity of all of the Bispecific T-cell Engager drugs discussed in this lecture?

Cytokine release syndrome, neurotoxicity

What is the source of T-cells infused in CAR-T therapy?

Genetically altered patient T cells

What medications should be used as pre-medication in patients receiving CAR-T therapy?

• Acetaminophen & H1 antihistamine

  • No H1 antihistamine for obecabtagene Autoleucel

  • Avoid prophylactic steroids in all

What class of medications should be avoided in patients receiving CAR-T therapy?

Steroids

What are the five categories of CAR-T toxicities?

1. Insertional oncogenesis

2. Neurological toxicity

   1. Confusion, delirium, aphasia, seizure 

3. Cytokine release syndrome

4. Anaphylaxis/Allergy

5. On target, off tumor toxicity