033 Developments in tumour immunology

Question 1

What are the 3 stages of cancer immunoediting

Answer 1

Elimination: immune cell destroys tumor
Equilibrium: tumor begins to resist immune cells by genetic instability and immune selection
Escape: tumor overpowers the immune system

Question 2

What does CD28 bind to on APC and is it co-stimulatory or inhibitory?

Answer 2

CD86 (B7.1/2)

Co-stimulatory

Question 3

What does PD1 bind to on APC and is it co-stimulatory or inhibitory?

Answer 3

PDL1/2

coinhibitory

Question 4

What does CTLA4 bind to on APC and is it co-stimulatory or inhibitory?

Answer 4

B7.1/2 (CD80/86)
Coinhibitory
Higher affinity

Question 5

What is nivolumab?

Answer 5

PD1 blocker

Question 6

What is a complication of anti-CTLA4’s? how would you manage this?

Answer 6

Autoimmunity

You would give corticosteroids

Question 7

What happens to tumor cells when T cells secrete interferon gamma?

Answer 7

Interferon gamma causes tumor cells to express more PDL1 expression, to bind to PD1 and send negative signal into T cells.

Question 8

Which types of tumors respond best to CTLA4 and PD1 blockers?

Answer 8

Tumors with more neoantigens