Oncology Has a New Class Of Drug
PD-1 and PD-L1 inhibitors are a new class of drugs that stimulate the immune system to kill cancer cells. The following are three FDA approved drugs
Atezolizumab (tecentriq) is a monoclonal antibody that targets PD-L1 (programmed cell death ligand 1 protein) blocking the interaction between PD-L1 and it ligands. The inhibition of PD-L1 expressed on tumor cells allows the T-cells to kill the cancer cells. Atezolizumab is administered intravenously over one hour. The most common side effects are fatigue, decreased appetite, nausea, GI disturbance, and rash. Liver function test needs to be monitored. Rare but potentially sever infusion reactions, pneumonitis and pancreatitis can occur. Atezolizumab is FDA approved for urothelial cancer, non-small cell lung cancer and melanoma.
Pembrolizumab (keytruda) is a monoclonal antibody that targets PD-1 (programmed cell death-1-protein) blocking the interaction between PD1 and it ligands PD-L1 and PD-L2 resulting in T-cell mediated killing of the tumor cells.
Pembrolizumab is administered intravenously over thirty minutes. The most common side effects are fatigue, anemia, elevated glucose, low sodium, nausea, and rash. Less common but more severe side effects are pneumonitis, hypothyroidism, and sepsis. In less than 1% nephritis and hepatitis can occur. Pembrolizumab is FDA approved for melanoma, non-small cell lung cancer, head and neck squamous cell cancer, and Hodgkins lymphoma.
Nivolumab (opdivo) is a monoclonal antibody toward PD-1 (programmed cell death-1-protein) that blocks the interaction between PD-1 and its ligands PD-L1 and PD-L2 resulting in cancer cell death T-cell mediated. Nivolumab is administered intravenously over one hour. The most common side effects are rash and increased liver function test, and low sodium.
Less common but more potentially severe are pneumonitis, hepatitis, nephritis and infusion reaction.
It is currently FDA approved for melanoma, non-small cell lung cancer, renal cell cancer, Hodgkin's lymphoma, head and neck cancer and urothelial carcinoma and will soon be FDA approved for additional cancers.