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Chief of Hematology/Oncology and Medical Director at Memorial Cancer Institute, and Clinical Associate Professor of Medicine at Florida International University

Chief of Hematology/Oncology
Medical Director of Memorial Cancer Institute

Lung Cancer Video Library - Spanish Language: Video #29 Similarities and Differences Among Immune Checkpoint Inhibitors
Tue, 02/07/2017 - 13:09
Author
Luis Raez, MD FACP FCCP, Faculty, Board Member
 
 

Similitudes y diferencias entre los diferentes inhibidores de puntos de control

Similarities and differences between the different checkpoint inhibitors

 

 Dr. Luis Raez, MD FACP FCCP,

Chief of Hematology/Oncology and Medical Director, Memorial Cancer Institute,
Clinical Associate Professor of Medicine, Florida International University

 

Spanish TRANSCRIPT

La otra pregunta que nos hacen es, ¿cuáles son las diferencias entre los inhibidores de los puntos de control entre los agentes inmunoterapeúticos?

Básicamente todos estos agentes bloquean el receptor PD1 del linfocito o bloquean el receptor PDL1 del tumor. SI ustedes recuerdan cuando el linfocito se acerca a matar al tumor, el tumor tiene un ligando PDL1 que cuando entra en contacto con el receptor del linfocito bloquea el ataque del linfocito, entonces el linfocito se va. Es importante bloquear esa interacción entre el ligando PDL1 y el receptor PD1. Así que, todas estas drogas inmunoterapeúticas bloquean el receptor PD1 como en el caso de nivolumab y pembrolizumab que están aprobadas para cancer de pulmón, o hay fármacos que bloquean el ligando PDL1 del tumor para que no pueda entrar en contacto con el linfocito y que lo mate.  

Hay varias drogas en desarrollo como atezolizumab que bloquean PDL1. Esa es una diferencia entre los dos, pero para propósitos prácticos no sabemos si los fármacos que bloquean PD1 son más efectivas que las que bloquean PDL1. Al final hacen el mismo efecto, pero no sabemos si eso hace una diferencia.

Una diferencia de practica es la forma en la que las administramos, nivolumab se da cada dos semanas, pembrolizumab se da cada tres semanas y hay otros fármacos inmunoterapeúticos que se dan hasta cada cuatro semanas. De repente, la forma de administración es una forma de distinguir entre ellas. No hay realmente mayores diferencias todavía entre ellas. Las toxicidades son bastante similares, porque son parecidas o del mismo tipo. Por lo que los efectos secundarios son los mismos hasta que encontremos algo en ellas que las diferencie unas de otras.


 

English TRANSCRIPT

The other question we receive is, what are the differences between the checkpoint inhibitors among the immunotherapeutic agents?

Basically these agents block the PD1 receptor in the lymphocyte or they block the PDL1 in the tumor. As you remember, when the lymphocyte starts the killing process, the tumor has the ligand PDL1 that when it interacts with the lymphocyte receptor, it blocks the lymphocyte attack, so the lymphocyte leaves without killing it. It’s important to block this interaction between the PDL1 ligand and the PDL1 receptor. So, these immunotherapeutic drugs block the PD1 receptor, like nivolumab and pembrolizumab that are already approved for lung cancer. There are also drugs that block the PDL1 ligand on the tumor so it doesn’t interact with the lymphocyte.

There are many drugs in development like atezolizumab that block PDL1. This is a difference between these two, but for practical purposes, we don’t know if these PD1 blocking drugs are more effective than the PDL1 blockers. At the end, their effect is the same, but we don’t know is that makes a difference.

A practical difference is the way we prescribed them, nivolumab is given every two weeks, pembrolizumab every three weeks and there are other immunotherapeutic drugs that are prescribed every four weeks. The way and time we give these drugs, is a way of distinguish them because there are no major differences among them. Finally, the toxicities are pretty similar because they are mainly from the same type.

 

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