Antineoplastics
Methotrexate
Pure As Gold:
Purines Adenine and Guanine
Pyrimidine = CUT:
Cytosine, Uracil, Thymine
- Hexagonal pyrimidine (T, C, U) shape: methotrexate, 5-fluorouracil, and hydroxyurea block synthesis of thymidine (pyrimidine nucleoside)
- Blocking DNA: inhibition of thymidine synthesis (by MTX, 5-FU, and hydroxyurea) inhibits DNA synthesis
- Sushi phase: antimetabolites (e.g. MTX and 5-FU) and hydroxyurea block the S phase of the cell cycle (DNA synthesis)
- Dumplings: deoxyuridine monophosphate (dUMP - precursor to dTMP)
- Dumpling with "T" shaped chopsticks: deoxythymidine monophosphate (dTMP)
- "C" sushi on a bed of 4 leaves: methylated tetrahydrofolate (N5,N10 Methylenetetrahydrofolate)
- Transferring "C" sushi: thymidylate synthase (catalyzes the conversion of methylated THF -> DHF and the methylation of dUMP -> dTMP)
- 2 leaves: dihydrofolate (DHF)
- Adding 2 leaves: dihydrofolate reductase (reduces DHF back to THF)
- 4 leaves: tetrahydrofolate (THF)
- Adding "C" sushi: THF is re-methylated to continue cycle
Methotrexate
- Blocked leaf chef: MTX irreversibly blocks dihydrofolate reductase (inhibits synthesis of THF)
- Meat stix: methotrexate (MTX - cytotoxic folate analog)
- Cracked cancer crab: MTX treats a range of malignancies (e.g. leukemias, lymphomas, breast cancer, head and neck cancer, and lung cancer)
- Emptying uterus bag: MTX (with misoprostol) can be used as an abortifacient
- Ectopic key chain: MTX treats ectopic pregnancy
- Dumping mole: MTX treats invasive molar pregnancy, trophoblastic tumors, and choriocarcinoma
- Silvery scale kneepads: MTX treats psoriasis
- Rheumatoid lantern with flame for inflammation: MTX is a first line treatment for rheumatoid arthritis (disease modifying antirheumatic drug - DMARD)
- Torn antibody: MTX is useful for immunosuppressive therapy (e.g. treatment of IBD, SLE, vasculitis, dermatomyositis)
- Buildup of 2 leaf boats: inhibition dihydrofolate reductase (by MTX) causes increased levels of DHF
- Falling foliage: MTX can cause folate deficiency
- Blasting fireworks: MTX can cause megaloblastic anemia (due to folate deficiency)
- Fibrotic lung bonsai: MTX can cause pulmonary fibrosis (restrictive lung disease)
- Liver spot: MTX can cause hepatotoxicity
- Bald: MTX can cause alopecia
- Poking mouth: MTX can cause mucositis
- Depleted bone pan: MTX, 5-FU and hydroxyurea can cause myelosuppression and pancytopenia
- Immunosuppressed cane: MTX, 5-FU and hydroxyurea can cause immunosuppression and increased risk of infection
Leucovorin
- Lucky feline: leucovorin (folinic acid) therapy can reverse the toxic effects of MTX ("leucovorin rescue"). Same as THF, does not require DHF reductase, replaces methotrexate inside cells
5-FU
- Full guy: 5-fluorouracil (5-FU - a cytotoxic pyrimidine analog)
- Full guy binding carbon donator: 5-FU complexes with THF and inhibits thymidylate synthase (block thymidine production from dUMP to dTMP)]
- Cracked cancer crab: 5-FU has activity against many solid tumors (e.g. colorectal, breast, head and neck, liver, pancreas, and basal cell cancers)
- Buildup of dumpling plates: inhibition of thymidylate synthase (by 5-FU) causes increased levels of dUMP
- Stained pants: 5-FU can cause diarrhea by killing rapidly dividing GI epithelium
- Sensitive photos: 5-FU causes a variety of cutaneous complications (e.g. including photosensitivity and hyperpigmentation reactions
- Knocked over lucky feline: leucovorin (folinic acid) does not prevent toxicities of 5-FU
- Depleted bone pan: MTX, 5-FU and hydroxyurea can cause myelosuppression and pancytopenia
- Immunosuppressed cane: MTX, 5-FU and hydroxyurea can cause immunosuppression and increased risk of infection
Hydroxyurea
- U-D-P: uridine diphosphate (UDP - precursor to pyrimidine nucleosides)
- Crossed out OXY: ribonucleotide reductase (converts UDP -> deoxy-UDP), then converted to dUMP
- Hydro-rock area: hydroxyurea (ribonucleotide reductase inhibitor)
- Inhibited wait list waitress: hydroxyurea inhibits ribonucleotide reductase (blocked thymidine synthesis)
- Cracked crab: hydroxyurea has activity against solid and hematologic malignancies (e.g. AML, CML, and head and neck cancer)
- Zen sickle: hydroxyurea reduces veno-occlusive crises in sickle cell anemia
- Raised baby with hemoglobin coin: hydroxyurea increases fetal hemoglobin (HbF) levels (protects against polymerization of mutated HbS)
- Depleted bone pan: MTX, 5-FU and hydroxyurea can cause myelosuppression and pancytopenia
- Immunosuppressed cane: MTX, 5-FU and hydroxyurea can cause immunosuppression and increased risk of infection
Azathioprine
- Pentagon pedestal with 3 P hammers: phosphoribosyl pyrophosphate (PRPP) (5 point ribose sugar with 3 phosphate) → precursor to IMP
- Gargoyle imp: inosine monophosphate (IMP) intermediate purine nucleotide → precursor to AMP and GMP)
- “Pure As Gold”: AMP and GMP are purine nucleotides
- GruMPy statue: guanosine monophosphate (GMP - purine nucleotide)
- grAMPs statue: adenosine monophosphate (AMP - purine nucleotide)
- Aza-meralda: azathioprine (AZA - prodrug of the cytotoxic purine analog 6- mercaptopurine)
- CAPTured gypsy: 6-mercaptopurine (6-MP - cytotoxic purine analog)
- HiGh PRiesT: Hypoxanthine-guanine phosphoribosyl transferase (HGPRT)
- HiGh PRiesT aggrevating captive: HGPRT activates 6-MP
- Captive toppling imp: AZA/6-MP blocks synthesis of IMP → decreased purine nucleotide synthesis → blocked DNA and RNA synthesis
- “Stairs out”: AZA/6-MP blocks the S phase of the cell cycle (DNA synthesis)
- Cracked antibody archers and T knights: 6-MP treats hematologic malignancies (e.g. ALL)
- Torn antibody: AZA/6-MP is useful for immunosuppressive therapy (e.g. treatment of graft rejection, SLE, autoimmune hemolytic anemia)
- Rheumatoid lantern: AZA/6-MP can be used to treat refractory rheumatoid arthritis (disease modifying antirheumatic drug - DMARD)
- Inflamed colonic lanterns: AZA/6-MP can be used to treat inflammatory bowel disease (i.e. crohn's disease, ulcerative colitis)
- Depleted birdseed marrow: AZA/6-MP and mycophenolate can cause myelosuppression
- Immunosuppressed cane: AZA/6-MP can cause immunosuppression and increased risk of infection
- Squeezed pancreas sponge: AZA/6-MP can cause pancreatitis
- Liver stain: AZA/6-MP can cause hepatitis
- Pure nuns: allopurinol is a xanthine oxidase (XO) inhibitor
- XO breaks down 6-MP
- Collection of purine beads: inhibition of XO increases levels of purine analogs (e.g. 6-MP) → increased risk of side effects
- Quasi-mofetil: mycophenolate mofetil (IMP dehydrogenase inhibitor)
- Quasi-mofetil topples GruMPy statue: mycophenolate inhibits IMP dehydrogenase → decreased GMP synthesis → decreased lymphocyte proliferation
- Torn antibody: mycophenolate is useful for immunosuppressive therapy (e.g. treatment of graft rejection, SLE, myasthenia gravis)
- Rheumatoid lantern: mycophenolate can be used to treat rheumatoid arthritis (disease modifying antirheumatic drug - DMARD)
- Nauseated: mycophenolate can cause GI distress (nausea, diarrhea, cramping)
- Depleted birdseed marrow: AZA/6-MP and mycophenolate can cause myelosuppression
- Immunosuppressed cane: mycophenolate can cause immunosuppression and increased risk of infection
Cladribine
- Clad in bearskins: cladribine (cytotoxic purine analog)
- Purine shaped hammer: cladribine is a purine analog
- Cracked replication fork: cladribine, cytarabine, and gemcitabine inhibit DNA polymerase
- Stone Phase: antimetabolites (e.g. cladribine, cytarabine, gemcitabine) inhibit the S phase of the cell cycle (DNA synthesis)
- Hairy caveman: cladribine treats hairy cell leukemia
- Broken marrow: cladribine, cytarabine, and gemcitabine can cause myelosuppression
- Immunosuppressed cane: cladribine, cytarabine, and gemcitabine can cause immunosuppression and increased risk of infection
- Saber toothed tiger: cytarabine (cytotoxic pyrimidine analog)
- Pyrimidine shapes: cytarabine and gemcitabine are pyrimidine analogs
- Cracked replication fork: cladribine, cytarabine, and gemcitabine inhibit DNA polymerase
- Stone Phase: antimetabolites (e.g. cladribine, cytarabine, gemcitabine) inhibit the S phase of the cell cycle (DNA synthesis)
- Gems inside geode: gemcitabine (cytotoxic pyrimidine analog)
- Pyrimidine shapes: cytarabine and gemcitabine are pyrimidine analogs
- Cracked replication fork: cladribine, cytarabine, and gemcitabine inhibit DNA polymerase
- Stone Phase: antimetabolites (e.g. cladribine, cytarabine, gemcitabine) inhibit the S phase of the cell cycle (DNA synthesis)
- Scratched out antibody archers and T-cell swordsmen: cytarabine is only active against hematologic malignancies (e.g. AML, non-Hodgkin lymphoma)
- Cracked crab fossil on solid rocks: gemcitabine is active against both hematologic malignancies and solid tumors
Cyclophosphamide, busulfan, nitrosoureas
- alkylating odyssy
- Cyclops polyphemus: cyclophosphamide (cytotoxic alkylating agent)
- Cross-linking ankle chains: alkylating agents donate an alkyl group → DNA cross-links (cell cycle NONspecific), N7
- Torn cancer crab: cyclophosphamide treats many hematologic and solid malignancies (e.g. leukemias and lymphomas, breast cancer, ovarian cancer)
- Torn antibody: cyclophosphamide is a potent immunosuppressive therapy (e.g. treatment of nephrotic syndrome, nephritic syndrome, vasculitis, autoimmune hemolytic anemia)
- Activating chrome bumper: cyclophosphamide is ACTIVATED by hepatic cytochrome P450 enzymes
- Broken marrow: cyclophosphamide can cause myelosuppression
- Red urine: cyclophosphamide can cause hemorrhagic cystitis
- Protective maze: coadministration of 2-mercaptoethanesulfonate (MESNA) prevents hemorrhagic cystitis. MESNA donates thiol group that inactivates toxic metabolite
- Cancer crab belt buckle: cyclophosphamide increases risk of bladder cancer (high grade transitional cell carcinoma)
- Inappropriately wet head: cyclophosphamide can cause hyponatremia due to SIADH
- Dried up fruit tree: cyclophosphamide can cause infertility and premature menopause
- Beautiful sirens: busulfan (cytotoxic alkylating agent)
- Severely depleted marrow: busulfan is useful as a conditioning agent prior to bone marrow transplantation
- Fibrotic lung pattern: busulfan can cause lung toxicity (e.g. acute lung injury, interstitial fibrosis, alveolar hemorrhage)
- Beautiful TAN sirens: busulfan can cause a hyperpigmentation reaction (“busulfan tan”)
- Centaurs: nitrosoureas (cytotoxic alkylating agents)
- Mustang: “-mustine” suffix of nitrosoureas (e.g. carmustine, lomustine)
- Striped zebra centaur: streptozotocin (nitrosourea - cytotoxic alkylating agent)
- Brain tree: nitrosoureas are highly lipophilic → cross BBB → treat brain tumors (e.g. glioblastoma multiform)
- Dizzy centaur: nitrosoureas can cause neurotoxicity (e.g. convulsions, dizziness, ataxia)
Cisplatin
- Platinum: cisplatin, carboplatin, oxaliplatin (cytotoxic platinum analogs)
- Cross-linked helix necklace: platinum analogs bind DNA and form intrastrand and interstrand cross-links, N7
- Crumpled crab: platinum analogs treat various solid malignancies (e.g. non-small cell lung cancer, small cell lung cancer, testicular cancer, ovarian cancer, bladder cancer)
- Ototoxic earrings: platinum analogs can cause ototoxicity → sensorineural hearing loss, tinnitus (especially cisplatin)
- Neuropathic gloves: platinum analogs can cause neurotoxicity → peripheral neuropathy (especially cisplatin)
- Nephrotoxic purse: platinum analogs can cause nephrotoxicity → acute kidney injury (especially cisplatin)
- Muddy drain tube: platinum analogs can cause acute tubular necrosis (ATN - muddy brown casts)
- Amethyst: amifostine (an organic thiophosphate) can prevent cisplatin-induced nephrotoxicity
- “Free, rare”: amifostine scavenges free radicals produced by cisplatin in the kidney
- Saline fluids: IV saline diuresis prevents cisplatin-induced nephrotoxicity
- Depleted bone jewelry box: platinum analogs can cause myelosuppression (especially carboplatin)
- Immunosuppressed cane: platinum analogs can cause immunosuppression and increased risk of infection (especially carboplatin)
Bleomycin
- Beluga whale: bleomycin (antitumor antibiotic)
- Oxide bubbles: bleomycin binds DNA and produces free radicals (superoxide, hydroxide)
- Broken double helix kelp: free radicals produced by bleomycin cause single and double strand breaks in DNA
- Galleon: bleomycin blocks the G2 phase of the cell cycle
- Cracked anticancer crab: bleomycin treats many hematologic and solid malignancies (e.g. Hodgkin and Non-hodgkin lymphoma, germ cell tumors, squamous cell carcinoma of the skin, cervix, and vulva)
- Lung coral: bleomycin can cause pulmonary toxicity (e.g. pneumonitis, pulmonary infiltrates)
- Hyperpigmented striae: bleomycin can cause skin toxicity (e.g. rash, exfoliation, hyperpigmentation, atrophic striae)
- Poking mouth: bleomycin (and anthracyclines) can cause mucositis and stomatitis
- Bald beluga: bleomycin can cause alopecia
- Santa Anthracycline: anthracyclines (antitumor antibiotics)
- Rubies: “-rubicin” suffix of anthracyclines (e.g. doxorubicin, daunorubicin)
- Oxide bubbles: anthracyclines produce free radicals (e.g. superoxide, hydroxide)
- Rubies inserting into helical seaweed: anthracyclines (e.g. doxorubicin) intercalate in DNA → block DNA and RNA synthesis
- Cracked cancer crab: anthracyclines (e.g. doxorubicin) treats a broad range of solid and hematologic malignancies
- Dilated heart ruby sacks: anthracyclines (e.g. doxorubicin) can cause cardiotoxicity (e.g. dilated cardiomyopathy). Free radicals
- Chelating the heart sack on deck: dexrazoxane (iron chelator) prevents anthracycline-induced cardiotoxicity
- Up on deck with razor: dexrazoxane (iron chelator)
- Depleted bone chest: anthracyclines (e.g. doxorubicin) and actinomycin D can cause myelosuppression
- Bald pirate: anthracyclines (e.g. doxorubicin) can cause alopecia
- Doll artifact: actinomycin D (antitumor antibiotic)
- Artifacts inserting into helical seaweed: actinomycin D intercalates in DNA → block DNA and RNA synthesis
- Child’s artifact: actinomycin D treats numerous pediatric malignancies (e.g. Wilms tumor, Ewing sarcoma, rhabdomyosarcoma)
- Bald doll: actinomycin D can cause alopecia
Etoposides
- Side of the tower: etoposide and teniposide (topoisomerase II inhibitors)
- Unwinding strands: topoisomerases relieve DNA supercoiling that occurs during DNA replication
- Grasping 2 strands: etoposide and teniposide inhibit topoisomerase II (double stranded breaks to relieve supercoiling)
- Both strands breaking: etoposide and teniposide prevent religation of the double strand break induced by topoisomerase II
- “Stairs out”: topoisomerase inhibitors block the S phase of the cell cycle (DNA synthesis)
- “Gone 2 forest”: topoisomerase inhibitors block the G2 phase of the cell cycle (double check and repair)
- Ripped cancer crab: etoposide and teniposide treat many solid and hematological malignancies (e.g. testicular cancer, small cell lung cancer, Hodgkin and non-Hodgkin lymphoma)
- Spilling bone luggage: topoisomerase inhibitors can cause myelosuppression
- Immunosuppressed cane: topoisomerase inhibitors can cause immunosuppression
- Losing hair: topoisomerase inhibitors can cause alopecia
- Toucan: topotecan and irinotecan (topoisomerase I inhibitors)
- Single ponytail strand: topotecan and irinotecan inhibit topoisomerase I (single strand nick to relieve supercoiling)
- Loose bird stool: topotecan and irinotecan can cause severe diarrhea
Vincristine
- Christine in vines: vincristine (cytotoxic vinca alkaloid)
- Breaking spindle vines: vinca alkaloids (e.g. vincristine, vinblastine) inhibit microtubule production and mitotic spindle assembly
- Blasting vines: vinblastine (cytotoxic vinca alkaloid)
- “M” shape in vines: drugs that affect microtubule function (e.g. vinca alkaloids, taxanes) block the M phase of the cell cycle (mitosis)
- Tarzan: taxanes (e.g. paclitaxel, docetaxel, cabazitaxel - cytotoxic plant alkaloids)
- Stabilizing the vine: taxanes enhance microtubule production and prevent their degradation → improper mitotic spindle function
- Cracked cancer crab: vinca alkaloids treat many hematologic and solid malignancies (e.g. leukemias, lymphomas, pediatric tumors, breast cancer, and germ cell cancer)
- Neuropathic stockings and gloves: vincristine can cause neurotoxicity (e.g. peripheral sensory neuropathy)
- Plunger: vincristine can cause autonomic dysfunction (e.g. paralytic ileus, constipation)
- Bald: vinca alkaloids (e.g. vincristine, vinblastine) can cause alopecia
- Broken marrow: drugs that affect microtubule function (e.g. vinca alkaloids, taxanes) can cause myelosuppression (especially vinblastine)
- Bald: taxanes (e.g. paclitaxel) can cause alopecia
- Neuropathic glove: taxanes can cause neurotoxicity (e.g. peripheral sensory neuropathy)
Kinase Inhibitors and Antibodies
- Broken nib: “-nib” suffix of small molecule kinase inhibitors (e.g. imatinib, erlotinib, vemurafenib)
- Inhibited tire swing: tyrosine kinase inhibitors (“-tinib” e.g. imatinib, erlotinib, sunitinib)
- Imitating: imatinib (small molecule tyrosine kinase inhibitor)
- British Earl: erlotinib (small molecule tyrosine kinase inhibitor)
- Rising sun: sunitinib (a small molecule tyrosine kinase inhibitor)
- Soaring eagle: sorafenib (a small molecule tyrosine kinase inhibitor)
- Venom: vemurafenib (a small molecule kinase inhibitor)
- Cracked crab: small molecule kinase inhibitors treat a variety of hematologic and solid malignancies (e.g. imatinib treats CML)
- Imitating: imatinib (small molecule tyrosine kinase inhibitor)
- Cracked crab: small molecule kinase inhibitors treat a variety of hematologic and solid malignancies (e.g. imatinib treats CML)
- Copious pink, white, and blue granules: chronic myeloid leukemia (CML) (increased levels of mature granulocytes - eosinophils, neutrophils, basophils)
- BREAKABLE: imatinib blocks the tyrosine kinase domain of the BCR/ABL fusion protein (in CML)
- Philadelphia, Pa: translocation between chromosomes 9 and 22 → BCR/ABL oncogene on chromosome 22 (Philadelphia chromosome)
- Congress kit: imatinib blocks the c-kit tyrosine kinase (in GIST)
- Crab buttons on belly: c-kit tyrosine kinase is found in gastrointestinal stromal tumors (GIST)
- Baggy pantaloons: imatinib can cause fluid retention → ankle and periorbital edema
- British Earl: erlotinib (small molecule tyrosine kinase inhibitor)
- Earl Geoffrey: erlotinib blocks the epidermal growth factor receptor (EGFR) tyrosine kinase
- Big lapel with crab badge: erlotinib treats solid tumors with EGFR overexpression (e.g. non-small cell lung cancer - NSCLC)
- Spotty rash: erlotinib can cause a papulopustular acneiform rash
- Muddy pantaloons: erlotinib can cause diarrhea
- Rising sun: sunitinib (a small molecule tyrosine kinase inhibitor)
- Soaring eagle: sorafenib (a small molecule tyrosine kinase inhibitor)
- Inhibiting vegetables: sunitinib and sorafenib inhibit the vascular endothelial growth factor receptor (VEGFR) tyrosine kinase
- Flank crab buckles: sunitinib and sorafenib treat cancer with VEGFR overexpression (e.g. renal cell carcinoma)
- Callused and sunburned: sunitinib and sorafenib can cause hyperkeratosis and skin
rashes
- Bleeding wound: VEGF-targeted therapies (e.g. sunitinib, sorafenib) are associated with
an increased risk of hemorrhage
- Venom: vemurafenib (a small molecule kinase inhibitor)
- B. Fra: vemurafenib blocks B-Raf kinase
- Disseminated ink: vemurafenib treats V600E BRAF positive malignant melanoma
Rituximab
- mab = antibody, monoclonal
- chimeric: still retains protein fragments from other animals
- monoclonal = from same cell line, target same antigen
- Tusks: cetuximab (monoclonal antitumor antibody)
- Coronation ritual: rituximab (antitumor monoclonal antibody)
- Beverage lady: bevacizumab (monoclonal antitumor antibody)
- Alms: alemtuzumab (monoclonal antitumor antibody)
- Tapestry weaver: trastuzumab (monoclonal antitumor antibody)
- Coronation ritual: rituximab (antitumor monoclonal antibody)
- Chimera sigil: rituximab and cetuximab are chimeric monoclonal antibodies (IgG)
- Pulling down antibody archer: rituximab depletes B cells (binds CD20), ADCC, treats CD20 positive non-hodgkins lymphoma
- Grabbing “XX” straps: rituximab binds CD20 on B-cells
- Chronic, worn out tapestry with antibody archers and T knights: rituximab treats chronic lymphocytic leukemia (CLL)
- Rheumatic lantern: rituximab treats rheumatoid arthritis (disease modifying antirheumatic drug - DMARD)
- Torn antibody: Rituximab is useful for immunosuppressive therapy (e.g. microscopic polyangiitis, Wegener’s granulomatosis)
- Immunosuppressed cane: Rituximab can cause immunosuppression, neutropenia, and increased risk of infection
- White laurel leaves: rituximab may be associated with a higher risk of progressive multifocal leukoencephalopathy (PML)
- Swollen cherub with ivy: monoclonal antibodies can cause an infusion reaction (e.g. headache, fever, skin rash, pruritus, dyspnea, hypotension) (cytokine release from B cells)
- Delayed onset poisoning: chimeric antibodies (e.g. rituximab) can cause serum sickness (e.g. fever, rash, arthralgia within 7-10 days) (deposition of immune complex, type 3) (immune system targeting mouse of antibody)
- Tusks: cetuximab (monoclonal antitumor antibody)
- Chimera sigil: rituximab and cetuximab are chimeric monoclonal antibodies (IgG)
- Giraffe: cetuximab binds the epidermal growth factor receptor (EGFR)
- Tire swing: EGFR is a receptor tyrosine kinase
- Cracked crab: cetuximab treats solid tumors (e.g. colorectal cancer, squamous cell carcinoma)
- Red spots: cetuximab can cause a papulopustular acneiform rash (EGFR expressed on skin)
- Delayed onset poisoning: chimeric antibodies (rarely cetuximab) can cause serum sickness (e.g. fever, rash, arthralgia within 7-10 days)
- Beverage lady: bevacizumab (monoclonal antitumor antibody)
- Chopped vegetables: bevacizumab binds VEGF
- Chopping vessels: bevacizumab inhibits growth of blood vessels in tumors (binds VEGF) (inhibit wound healing)
- Cracked crab: bevacizumab treats metastatic tumors (e.g. colorectal cancer, lung cancer)
- Wet center of retina pillow: bevacizumab treats wet macular degeneration
- Blood spatter: bevacizumab can cause bleeding
- Ice clots: bevacizumab increases the risk for thrombotic events, TIA, strokes, angina
- Perforating colon bag: bevacizumab can cause GI perforation (sudden abdominal pain)
- Alms: alemtuzumab (monoclonal antitumor antibody)
- Pulling down antibody archer and T knight: alemtuzumab depletes B and T cells (binds CD52)
- 52 pattern: alemtuzumab binds CD52 on B and T cells, ADCC
- Chronic tapestry with antibody archers and T knights: alemtuzumab treats chronic lymphocytic leukemia (CLL)
- Tapestry weaver: trastuzumab (monoclonal antitumor antibody)
- Her 2 babies: trastuzumab binds epidermal growth factor receptor 2 (HER2, c-erbB2)
- Tire swing: HER2 is a receptor tyrosine kinase
- Crab bra: trastuzumab treats HER2 positive breast cancer
- Unraveling heart: trastuzumab can cause cardiotoxicity (e.g. decreased LVEF, heart failure)