Immunotherapy: Monoclonal Antibodies & Oncolytic Viruses

Which symptom should patients receiving monoclonal antibodies be instructed to monitor for and report immediately?

What is the mechanism of action of monoclonal antibodies like ipilimumab and nivolumab?

What precaution should female patients of childbearing age take when receiving talimogene (Imlygic)?

What should be done to treatment sites after talimogene administration?

What are patients advised to do if they develop symptoms of motor or sensory deficits while on monoclonal antibody therapy?

Which of the following side effects is associated with the use of talimogene?

What instructions should patients receiving monoclonal antibody therapy follow regarding immune-mediated reactions?

Which of the following monitoring practices is important for patients on monoclonal antibodies?

Monoclonal Antibodies

Drug examples: ipilimumab (Yervoy), nivolumab (Opdivo), pembrolizumab (Keytruda)
Mechanism: Bind to cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), enhancing T-cell activation against melanoma cells.
Monitoring:
- Liver function tests (LFTs) and thyroid function tests
- Symptoms of enterocolitis, hepatotoxicity, and dermatitis
- Motor and sensory deficits
- Adrenal insufficiency, hyper- or hypothyroidism
Patient Education:
- Risk of severe and fatal immune-mediated reactions
- Immediate notification of healthcare provider (HCP) if symptoms occur
- Report symptoms of enterocolitis, hepatitis, skin reactions, neuropathies, endocrinopathies, pneumonitis, nephritis, or encephalitis.

Oncolytic Virus

Drug example: talimogene (Imlygic)
Mechanism: Genetically modified attenuated herpes simplex virus (HSV 1) that infects and kills melanoma cells.
Monitoring:
- Flulike symptoms (fatigue, nausea, fever, chills) or pain at the treatment site.
Patient Education:
- Potential for virus spread to other body areas or close contacts
- Pregnant and breastfeeding women should avoid this medication
- Avoid direct contact between treatment site, dressings, or body fluids and close contacts
- Wear gloves for dressing changes
- Keep treatment sites covered for at least a week after each treatment and replace loose or fallen dressings
- Dispose used dressings in sealed plastic bags.
- Do not touch or scratch the treatment site
- Immediate notification of HCP if symptoms of herpes infection develop (pain, burning or tingling in a blister around the mouth, genitals, fingers, or ears), eye pain, discharge, blurred vision or sensitivity to light, weakness in arms or legs, extreme drowsiness, or mental confusion.

This quiz covers the key concepts of monoclonal antibodies like ipilimumab and nivolumab, including their mechanisms and monitoring processes. It also explores the role of oncolytic viruses in cancer treatment, specifically focusing on talimogene. Test your knowledge on drug mechanisms, patient education, and side effects in melanoma therapy.