Checkpoint Inhibitors: Clinical Use and Adverse Effects

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Which immune checkpoint protein limits T-cell activation by outcompeting CD28 for binding to B7?

CTLA-4 (correct)

MHC

PD-1

CPK

What is the mechanism of action of ipilimumab in enhancing T-cell activation?

Augments PD-1 expression

Binds to CTLA-4 on APCs (correct)

Inhibits MHC presentation

Blocks PD-L1 interaction

Which protein does PD-L1 bind to on the surface of activated T cells?

MHC

PD-1 (correct)

CTLA-4

CD28

What adverse effects are associated with ipilimumab use?

Fatal immune-mediated adverse effects Signup and view all the answers

Which immune checkpoint inhibitor enhances T-cell priming through blocking of CTLA-4?

Ipilimumab Signup and view all the answers

What role do costimulatory signals play in activating T cells?

Enhancing T-cell activation Signup and view all the answers

What is the mechanism of action of Everolimus?

Inhibition of VEGF and HIF-1 expression Signup and view all the answers

What is the adverse effect of Everolimus that comes with a black box warning?

Myelosuppression Signup and view all the answers

In what type of cells is PI3Kδ highly expressed?

Malignant lymphoid B-cells Signup and view all the answers

How does Idelalisib act in malignant tumor cells?

Inhibits PI3Kδ Signup and view all the answers

What is the clinical use of Everolimus?

Renal cell carcinoma Signup and view all the answers

Why do researchers develop treatments that inhibit PI3K?

To control uncontrolled cell growth in some cancers Signup and view all the answers

Which adverse effect can be anticipatory, acute, or delayed in chemotherapy?

Nausea and Vomiting Signup and view all the answers

What is the mechanism of action of Nivolumab?

Inhibits PD-1 pathway Signup and view all the answers

Which type of cancer can be treated with Nivolumab?

Lung cancer Signup and view all the answers

What is a common adverse effect of chemotherapy drugs?

Vomiting Signup and view all the answers

Which adverse effect is associated with Nivolumab and can include Stevens-Johnson Syndrome?

Rash Signup and view all the answers

When does delayed vomiting typically occur after chemotherapy drug administration?

2-3 days later Signup and view all the answers

Which of the following is a characteristic of tumor lysis syndrome?

Hypouricemia Signup and view all the answers

What can help reduce the risk of tumor lysis syndrome?

Allopurinol Signup and view all the answers

What is the most common symptom in a neutropenic patient with bacterial infection?

Fever Signup and view all the answers

Which drug is used for the management of febrile neutropenia by promoting neutrophil production?

Filgrastim Signup and view all the answers

What adverse effect may be seen after the infusion of biologic drugs like recombinant cytokines and antibodies?

Cytokine release syndrome Signup and view all the answers

Which abnormality is commonly associated with Tumor Lysis Syndrome?

Hypocalcemia Signup and view all the answers

Why are normal tissues with rapid proliferation, like bone marrow, hair follicles, and intestinal epithelium, susceptible to damage from cytotoxic drugs?

Because these tissues have a high percentage of proliferating cells. Signup and view all the answers

Why is combination chemotherapy used in cancer treatment?

To enhance efficacy while minimizing dose-limiting toxicity. Signup and view all the answers

What makes it difficult to specifically target cancer cells?

Their altered nature similar to normal cells. Signup and view all the answers

Why do most cancer drugs have a narrow therapeutic window?

To limit toxicity while maintaining effectiveness. Signup and view all the answers

What is the purpose of using drugs that reverse or prevent toxicity to cancer chemotherapy drugs?

To minimize the risks of chemotherapy-induced toxicity. Signup and view all the answers

Why are cancers with a high percentage of proliferating cells most susceptible to chemotherapy?

Because their high rate of division makes them vulnerable to cytotoxic effects. Signup and view all the answers