Immunotherapies and checkpoint inhibitors — Flashcards

Flashcard 1: Ipilimumab is a checkpoint inhibitor that binds to _____ on T cells.

Answer: CTLA-4

Flashcard 2: Carfilzomib and Bortezomib are examples of antineoplastics that work by inhibiting the _____

Answer: proteasome

Flashcard 3: Erlotinib therapy is associated with _____ and diarrhea (adverse effects)

Answer: acneiform skin rash

Flashcard 4: Because Pembrolizumab targets a peripheral tolerance mechanism, patients taking this drug can develop autoimmune disorders of _____ organs

Answer: endocrine

Flashcard 5: Nivolumab is an anti-checkpoint monoclonal antibody that binds to _____ on T cells.

Answer: PD-1

Flashcard 6: Mechanism and indication of Anastrozole?

Answer: Aromatase inhibitor used in postmenopausal breast cancer

Extra: Mechanism: Competitively inhibits aromatase, decreasing estrogen synthesis. Indication: ER-positive breast cancer in postmenopausal women. Examples of other aromatase inhibitors: Letrozole, Exemestane.

Flashcard 7: Mechanism of action of Exemestane:

Answer: Irreversible (Steroidal) Aromatase Inhibitor

Extra: Mechanism: Irreversible inhibition of the enzyme aromatase. Indication: Breast cancer in postmenopausal women. Note: Exemestane is a steroidal inhibitor, unlike Anastrozole and Letrozole which are non-steroidal (reversible).

Flashcard 8: alkylating agents

Answer: absence of digits (and multiple varied anomalies)

Flashcard 9: Teratogenic effect of folate antagonists?

Answer: Neural tube defects (NTDs)

Extra: Folate antagonists (e.g., Methotrexate, Aminopterin) interfere with DNA synthesis and are potent teratogens. Maternal use, especially during the first trimester (organogenesis), is strongly associated with neural tube defects. Low folate levels in general are a risk factor, which is why folic acid supplementation is recommended preconceptionally.

Flashcard 10: What is the mechanism of action of Methotrexate (MTX)?

Answer: Inhibits dihydrofolate reductase (DHFR)

Extra: Methotrexate is a folate analog that competitively inhibits DHFR, leading to a decrease in dTMP and DNA synthesis. In contrast, Trimethoprim inhibits bacterial DHFR and Pyrimethamine inhibits protozoal DHFR.