FRCPath Haem Part 1 MCQ-Oncology 387
- amirhayat2527
- 1 day ago
- 0 min read
A 60yr-old Pt with DLBCL is receiving Pola-RCHP. He develops peripheral neuropathy during treatment. Which property of drug best explains this adverse effect?
Complement activation on peripheral nerves
Antibody cross-reactivity with neural antigens
Inhibition of DNA topoisomerase II
Disruption of microtubule assembly
Correct Answer: Disruption of Microtube Assembly
Polatuzumab is an antibody–drug conjugate. The antibody targets CD79b, but the toxicity comes from its payload:
Monomethyl auristatin E (MMAE)
A microtubule inhibitor (antimitotic), very similar in effect to vinca alkaloids
Key property explaining peripheral neuropathy:
Neurons rely heavily on intact microtubules to move materials along long axons, so tubulin-binding drugs commonly cause dose-dependent peripheral neuropathy.
Bottom line: The adverse effect is best explained by the drug’s microtubule-inhibiting (antitubulin) cytotoxic payload delivered via an antibody–drug conjugate.