II. Indications

  1. Neuroblastoma
  2. Melanoma (experimental)

III. Mechanism

  1. Ganglioside GD2
    1. GD2 is the cell surface receptor Glycolipid disialoganglioside
      1. GD2 functions as a part of development and differentiation pathways
    2. GD2 is expressed on all tumors of neuroectodermal origin
      1. Includes Melanoma, Neuroblastoma, Sarcoma, astrocytoma, Small Cell Lung Cancer
  2. GD2 Monoclonal Antibody (e.g. Dinutuximab)
    1. Chimeric mouse-human Monoclonal Antibody that binds cells expressing GD2 on their surface
    2. Antibody binding induces cytotoxicity (complement and Cell-mediated)

IV. Dosing

  1. See other references for disease specific dosing protocols

V. Adverse Effects

  1. Infusion Reaction
  2. Neurologic
    1. Severe neuropathic pain
    2. Transverse Myelitis
    3. Vision changes
  3. Electrolyte abnormalities
    1. Hyponatremia
    2. Hypokalemia
    3. Hypocalcemia
  4. Cytopenia
    1. Lymphopenia
    2. Thrombocytopenia
    3. Neutropenia
  5. Cardiovascular
    1. Hypotension
    2. Capillary leak syndrome
  6. Other common adverse effects
    1. Elevated Liver Function Tests
    2. Urticaria
    3. Fever

VI. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters, Pregnancy category X)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count with differential and Platelet Count
    2. Serum Electrolytes (including Sodium, Potassium, Calcium)
    3. Liver Function Tests

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