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edenmartinez · 2 years

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Test of diagnosis

Level Antidrug concentracion high Concentration can result increase toxicity

Low result in efficary biologics

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Dancomycin angentamycin in sepsia

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considerations in the treatment inclusive options treatment

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benefict of patient pharmaeconomic

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Monitorizing Drug with inmunohilatores to antibodys Of immunogenocity..

Certolizumab pegol >20

Golimumab post induction > 10

Vedolizumab > 3

Ustekinomab > 5

Cledolizumab week >2,4 10 Cledoligimen. week 2,8 post induction, 8, 3, 5

of week 14 levels prediting duabiling

Sustained

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One consicered

GERD = Sistema immurdagico

Para prevenir el rechazo de receptores de transplantes de Organos

Hermozona: Crema con conicoides

metametazona:

Fusicor en gel

What are antibodys - Drug congugates monoclonal antibodys Linked to a

cytotoxic drug des to -n the therapeulic window by focusing a delivery to specifics cells.

*Tumor antigen *binding site

*monoclonal antibody

* selective for antigeno

with high copy numbers in target tumor celk with minimal inmyngenic response.

Linkers Can be cleavable (a temo Cells,

Linkers Can be cleabank via tumor- associated factors) or non-cleaVable (via tumor associated factor of monel cavable (Lysosomalal degration

Payload:enhances cytoxicity althoughes eysepricity although antibody raty afecct and clearance

Antibody bind target antiger. →

Internalizes

bystander ged

Any's inderensing

payload releas +

Antibody Drug congugates: Mechanism of action

• Antibody binds target antigen Internalized → 7 Payload release ADCS may circulate as dynamic mixture of context congujate, naked antibodys,

Conjugate, naked antibody, and free payload

ADCS reach tumors via capiliares releasing some payload in tumor micro enviroment aa diffuse toward target

Antibody engagement payload independt antitumor activity

ADL reach tumors the capiliares relearing some payload in micro environment as diffusse Toward target

Antibody engagement payload- independent antitumor activity disruptionof receptor receptor dimerised and of funtion leads to disruption of downstream signaling

ADCS: More than the Sum of their parts

Efective in heavily pretreated patient of those who have resistance B testiment antibody or chemotherapy components may be due to a superior therapeutic index Components vary, eg, FDM1 vs I-Dxd! vs Additive benefit from best. bystander Effect

Identifying the mechanist of effacey is challenging given multiple contributing part

ACDS toxicityies

Grade 3/4 Neutropenia by ADC on targeted

ADC pivatuzumab off target an off tumor more difusse payload release inadverted cellular uptake.

Anemia, neutropenia seen with many ADCS unknow pulmonary toxicities with many ADCS unknow pulmonary with t-Dxd

THC immunohistochemistry

predictive biomarkers for ADCs hard to establ

•Where will ADCs for within the current

treatment Poradion lung cancer?

•

Consideration of ADCs in combination with agent that increase APC delivery mallare larget antigen gym anns an for intertaligatior Promore ant hilmor dymanges arm for inertia immunity,

in common, up Be complex bypass incon Opideline (ACD prete inst)

by an antybood drug conjugates web expelled EGFR mutada con mopositive tumor with adquired resistance To EGFR Targered

Halganior promore antllemor

is Antigen is the ADC. ressistention to Antibodies monactive From Tumor cell vier endes gonna deciding, prior to praylord Teles

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example Urothelia Camer

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operacion (Surgery 2 operasion (Surgery)

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cancer issues hemotherapy or Quote

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Progresion Oh Bsimer Minib subpectos

• in brain MRT and chary alderman/pelu Canis Whether special circumpla are Te present

Obiopsy of progressing Jesion and submit Praglesion Oh astmer tinib Subpected • aukin brain MRT and chesy abdomen/ pelvis C. Radiographic progression confirmed: Consider Whether special, Circulptances are btain Pace present

•

Obiopsy of progressing lesion and submit for biomarker testing Consider Liquid

biopsy, if tissue biopsy not feasible but less sensitive for fusiony transformations Oligome ometastatic continue IX with addition of log ablati ⚫rows and/or asymptomatic. Continue to beyond progression. CNS only. If Limited, continue tx with addition

if diffuse transition to CNS-penetrant Systemic

Progression on Osimerinibs. Supped to

dotein brain MRI and Chess/aboomen, Pagraphy of progresing confirmed! Consider whether special circumstances are Stain Cissie present

o r biopsy of progresing lesion and Submit for biomarker testing? copsy of tissue

propry nor feaside, but less sensitive for fusion/ transformation

bypass pathways

⚫clinical trial of Combined EGFR/MET

Inhibition

• Os metinib + Met inhibitor (eg, ergotiniby Te porini, capmatinib

clinical trial fusion RET: Osimer Tinibt

Get Inhibitor (eg, Praketing selerica ⚫ ARK: Osimertive FALK

Rost osimertinibt

ROSTRI

Anexo.

maintenance Therapy observation

Osimetinib is almost in chele Considerated

is the standar of care Chemo Therapy

(Histology evalue, planning

Long Cancer Anemia >EGFR

PHASE III

Pembrolizumab - Carboplatin /

permetraxes.co alone in Advanced NSCLC Vs Chemotherapy add EGFR mutations with L858R ESERT Therapy

mechanism or fusion of the rage

transformation of histology teatro follow

up with cert Tray, abdomen of conformed Prakes

Ifirst chermerherapy 2 on therapy I will foreining

homeostasy Metastasis

trombotic Nervious sistem

tratamiento inadyuvante in patology

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Peace dose gradually avoid disease High doses decrease song every 1-2 days

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Starting at 10 ming day, decrease by 2,5 mg every 1-2 weeks. mild dermal and Join autores. implicated Short Courses of Cortecorsticoide

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