Diferencia entre revisiones de «Oncologic therapy related adverse events»
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==CAR-T cells medications==
==CAR-T cells medications==
===Tisagenlecleucel (Kymriah)===
===Tisagenlecleucel (Kymriah)===
*Indications:  
Indications:
**Acute lymphoblastic leukemia
*Acute lymphoblastic leukemia
**Large B-cell lymphoma
*Large B-cell lymphoma
Adverse events include:
*[[Cytokine release syndrome]]
*[[Hypogammaglobulinemia]]
*[[Pancytopenia]]
*[[Altered mental status]]
===Axicabtagene ciloleucel (Yescarta)===
Indications:  
*Acute lymphoblastic leukemia
*Large B-cell lymphoma
*Adverse events include:
*Adverse events include:
**[[Cytokine release syndrome]]
*[[Cytokine release syndrome]]
**[[Hypogammaglobulinemia]]
*[[Pancytopenia]]
**[[Pancytopenia]]
*[[Altered mental status]]
**[[Altered mental status]]
===Axicabtagene ciloleucel (Yescarta)===
*Indications:
**Acute lymphoblastic leukemia
**Large B-cell lymphoma
**Adverse events include:
**[[Cytokine release syndrome]]
**[[Pancytopenia]]
**[[Altered mental status]]


==PD1 Monoclonal Antibodies==
==PD1 Monoclonal Antibodies==

Revisión del 18:24 6 mar 2020

Background

Many of the oncologic therapies currently employed involved immune system checkpoint inhibition which allow for improvement of T-cell activation towards cancer cells. This boost to the immune system can occur by many mechanisms that encompass the list of "novel" oncologic agents" described below.[1]

Clinical Features

  • Many novel oncologic therapies and Biologic immunomodulators adverse reactions may mimic common ED presentations such as sepsis.

Types of novel oncologic agents

  • Genetically engineered T cells
    • CD19–chimeric antigen receptor (CAR)-T cell therapy
  • Monoclonal Antibodies against PD-1 checkpoints
  • Small-molecule inhibitors
  • Monoclonal antibodies against cell surface antigens
  • Antibody-drug conjugates
  • Immunotoxins
  • Bispecific T-cell engagers

Differential Diagnosis


CAR-T cells medications

Tisagenlecleucel (Kymriah)

Indications:

  • Acute lymphoblastic leukemia
  • Large B-cell lymphoma

Adverse events include:

Axicabtagene ciloleucel (Yescarta)

Indications:

PD1 Monoclonal Antibodies

Pembrolizumab (Keytruda)

  • A PD-1 humanized mouse mAb
  • Adverse events include:
    • Infusion reactions
    • Musculoskeletal pain
    • Dyspnea
    • Diarrhea
    • Arrhythmias
    • Myocardial infarctions
    • Pericardial effusions

Nivolumab (OPDIVO)


Small molecule inhibitors

Enasidenib (IDHIFA)

Adverse Events:


Ivosidenib (Tibsovo)

Adverse events

Midostaurin (Rydapt)

Adverse Events:

Nilotinib (Tasigna)

Adverse events

Bosutinib (Bosulif)

Adverse Events:

Ibrutinib (Imbruvica)

Adverse Events:


Acalabrutinib (Calquence)

Adverse Events:

Duvelisib (Copiktra)

Adverse Events:

Copanlisib (Aliqopa)


Panobinostat lactate (Farydak)

Adverse Events:

Ixazomib citrate (Ninlaro)

Adverse Events:

Venetoclax (Venclexta)

Adverse Events:

Monoclonal antibodies against cell surface antigens

Ofatumumab (Arzerra)

Adverse Events:


Obinutuzumab (Gazyva)

Adverse Events:


Daratumumab (Darzalex)

Adverse Events:

Elotuzumab (Empliciti)

Adverse Events:

Empliciti (Poteligeo)

Adverse Events:

Antibody-drug conjugates

Inotuzumab ozogamicin (Besponsa)


Gemtuzumab ozogamicin (Mylotarg)


Brentuximab vedotin (Adcetris)

Immunotoxin

Moxetumomab pasudotox-tdfk (Lumoxiti)

Bispecific T-cell engager (Blincyto)

Blinatumomab

Disposition

See Also

External Links

References

  1. ↑ Shah, M., Rajha, E., DiNardo, C., Muckey, E., Wierda, W. G., & Yeung, S. C. J. (2020). Adverse Events of Novel Therapies for Hematologic Malignancies: What Emergency Physicians Should Know. Annals of Emergency Medicine, 75(2), 264–286. https://doi.org/10.1016/j.annemergmed.2019.07.015
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