What’s in a Name?
Say what?
Cancer immunotherapies can have some mind-boggling names. But there’s a reason for it all, and I’m here to try to elucidate the naming practices!
Monoclonal Antibodies
Monoclonal antibodies are molecules, generated in the lab, that target specific antigens on tumors. Take?rituximab, otherwise known as?Rituxan?, the first monoclonal antibody approved for cancer, in 1997 for non-Hodgkin lymphoma. You will probably understand the?-mab?portion of it—it is a monoclonal antibody. But did you know that it also tells you that it targets the tumor and that it’s a chimeric—partially mouse and partially human—monoclonal antibody??-tu-?is for tumors. (Rituximab targets CD20 expressed on B cells.) And?-xi-?stands for chimeric. The?ri-?is a unique name supplied by the drug’s developer.
Rituximab:
Stem
What it Means
ri-
unique name
-tu-
tumors
-xi-
chimeric
-mab
monoclonal antibody
Checkpoint Inhibitors
Now take?ipilimumab, known as?Yervoy?, an anti-CTLA-4 antibody. It was the first checkpoint inhibitor approved in 2011. Checkpoint inhibitors work by “taking the brakes off” the immune response, enabling a stronger attack against cancer. You can tell ipilimumab is different from rituximab because of the?-lim-?involved. This means that it targets the immune system, not a tumor. The?-u-?is for it being a fully human antibody.
Ipilimumab:
Stem
What it Means
ipi-
unique name
-lim-
immunomodulator
-u-
fully human
-mab
monoclonal antibody
Since ipilimumab was developed, the stem for immune modulators was shortened to just -li- or -l-. Names like this include?pembrolizumab, known as?Keytruda?, and?nivolumab, known as?Opdivo?, which are anti-PD-1 antibodies that were approved in 2014.
Therapeutic Cancer Vaccines and Adoptive Cell Therapy
Okay, that was easy. Let’s get to the hard stuff now—therapeutic cancer vaccines and adoptive cell therapy. Cancer vaccines are designed to elicit an immune response against tumor-specific or tumor-associated antigens. Adoptive T cell transfer is removing T cells from the patient, genetically modifying or treating them with chemicals to enhance their activity, and then re-introducing them into the patient. There are a number of names that come with these treatments.
Let’s start with the therapeutic cancer vaccine?sipuleucel-T—otherwise known as?Provenge?. It was approved in 2010 for the treatment of prostate cancer. I know from the name that it takes white blood cells out of the patient, pulses it with a cancer-bearing peptide or tumor, and reinserts it. How did I know that?
The suffix is?-cel, so I know that it is a cellular therapy. The hyphenated?-T?means it’s autologous, meaning its cells come from the patient. The white blood cells come from?-leu-, and I know they get pulsed with a cancer protein by the?-pu-. Only the?si-?is from the company!
Sipuleucel-T:
Stem
What it Means
si-
unique name
-pu-
pulsed with a cancer protein
-leu-
white blood cells
-cel
cellular therapy
-T
autologous
Now consider the adoptive cell treatment called chimeric antigen receptor (CAR) T cell therapy. This also has the suffix?-cel. In?tisagenleceucel-T?(CTL019), it also has the?-leu-?and the?-T?hyphenated. But CAR T cells are genetically engineered immune cells. We get this from?-gen?and?-lec.
Tisagenlecleucel-T:
Stem
What it Means
tisa-
unique name
-gen-
transfer of genetic material (transduced)
-lec-
selection and enrichment manipulation
-leu-
white blood cells
-cel
cellular therapy
-T
autologous
For non-cellular therapies, we find the suffix?-imut. They are off-the-shelf cancer vaccines, which use a protein, or fragment of it, to stimulate the immune response. You might have seen?rindopepimut?(CDX-110) in a phase III clinical trial for brain cancer.?-pep?is used for peptides.
Rindopepimut:
Stem
What it Means
rindo-
unique name
-pep-
peptides
-imut
non-cellular therapy.