Harvey's Garden

Monoclonal antibodies

2 min read

Oncology

  • Trastuzumab (Herceptin)

    • Target: HER2/neu (a receptor tyrosine kinase).
    • Use: HER2-positive breast and gastric cancer.
    • Buzzwords/Pearls: “Trust-Her-2” stick together. Significant adverse effect is cardiotoxicity (reversible); must check ejection fraction (echocardiogram) before and during treatment.

  • Rituximab

    • Target: CD20 antigen on B-cells.
    • Use: B-cell non-Hodgkin lymphoma (NHL), chronic lymphocytic leukemia (CLL), rheumatoid arthritis, ITP.
    • Buzzwords/Pearls: “Ritu-CD20-mab” helps remember the target. Causes B-cell depletion. Increased risk of Progressive Multifocal Leukoencephalopathy (PML).

  • Bevacizumab

    • Target: VEGF (Vascular Endothelial Growth Factor).
    • Use: Solid tumors (colorectal, lung cancer), wet macular degeneration.
    • Buzzwords/Pearls: Think “BEV” for Blood EVessel inhibitor. Inhibits angiogenesis. Adverse effects include hemorrhage, blood clots, and impaired wound healing.

  • Cetuximab

    • Target: EGFR (Epidermal Growth Factor Receptor).
    • Use: Stage IV colorectal cancer (only for KRAS wild-type), head and neck cancer.
    • Buzzwords/Pearls: Side effects include an acneiform rash (papulopustular) and diarrhea. Think Cetuximab for Colorectal Ca and rash.

  • Checkpoint Inhibitors (e.g., Pembrolizumab, Nivolumab, Atezolizumab)

    • Target: PD-1 (on T-cells) or PD-L1 (on tumor cells).
    • Use: Melanoma, lung cancer, and many other solid tumors.
    • Buzzwords/Pearls: “Unleashes” the immune system to attack cancer. Can cause widespread autoimmune side effects (e.g., colitis, pneumonitis, endocrinopathies). Think “-mab” unleashing “mayhem” on the tumor by taking the “brakes” off T-cells.

Immunology/Rheumatology

  • Infliximab, Adalimumab, Golimumab, Certolizumab

    • Target: TNF-α.
    • Use: Autoimmune conditions (rheumatoid arthritis, ankylosing spondylitis, psoriasis, inflammatory bowel disease).
    • Buzzwords/Pearls: “TNF-α gets INFLIX-ion” (inflicts damage). Before starting, must screen for latent TB (PPD or IGRA) as it can cause reactivation.

  • Eculizumab

    • Target: Complement protein C5.
    • Use: Paroxysmal nocturnal hemoglobinuria (PNH), atypical hemolytic uremic syndrome (aHUS).
    • Buzzwords/Pearls: Prevents formation of the MAC (Membrane Attack Complex). Patients require vaccination against Neisseria meningitidis due to increased risk of infection.

  • Ustekinumab

    • Target: IL-12 and IL-23.
    • Use: Psoriasis, psoriatic arthritis, Crohn’s disease.
    • Buzzwords/Pearls: Think “U-SITE-O-KIN-umab” for its action on cytokines IL-12/23.

Cardiology/Hematology

  • Abciximab
    • Target: Glycoprotein IIb/IIIa receptor on platelets.
    • Use: Antiplatelet agent for percutaneous coronary intervention (PCI).
    • Buzzwords/Pearls: Think “ABC-six-imab” sounds like “IIb/IIIa-mab”. Prevents platelet aggregation.

Other High-Yield Agents

  • Denosumab

    • Target: RANKL (Receptor Activator of Nuclear factor Kappa-B Ligand).
    • Use: Osteoporosis (mimics osteoprotegerin), bone metastases.
    • Buzzwords/Pearls: “Deno-su-mab” for Density of bone.

  • Omalizumab

    • Target: IgE.
    • Use: Severe, refractory allergic asthma.
    • Buzzwords/Pearls: Binds free IgE, preventing mast cell activation. Think “O-my-GEE” for IgE.

  • Palivizumab

    • Target: RSV F-protein (Respiratory Syncytial Virus).
    • Use: RSV prophylaxis for high-risk infants (e.g., premature, chronic lung disease).
    • Buzzwords/Pearls: This is a passive immunization for prophylaxis. Think “Pali-VIZ-umab” for RSV.

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