20.4 Molecular Approaches to Cancer Treatment

Question 1

the most effective way to deal with cancer is to ()

Answer 1

prevent the development of the disease

Question 2

second-best way to deal with cancer is ()

Answer 2

reliable early detection of premalignant stages that can be treated easily

Question 3

many cancers can be cured by () before they metastasize

Answer 3

localized treatment

Question 4

why is it important to take into consideration the selectivity of drugs targeted for oncogenes

Answer 4

oncogene blocking can also affect proto-oncogene activity needed for normal cell function

Question 5

most oncogene-targeted drug therapies target ()

Answer 5

specific oncogene proteins

Question 6

() of oncogene proteins (e.g. protein kinases) are also being developed as a means of dealing with cancer

Answer 6

small molecule inhibitors

Question 7

() is an inhibitor of the bcr/abl tyrosine kinase → blocks proliferation of chronic myeloid leukemia cells

Answer 7

imatinib or Gleevec

Question 8

resistance to imatinib most often results from mutations of the bcr/alb domain that ()

Answer 8

prevent imatinib binding

Question 9

imatinib is also a potent inhibitor of the (1) and the (2) → effective therapy for cancers that resulted from the oncogenic activation of the genes encoding these proteins

Answer 9

1. PDGF receptor
2. Kit tyrosine kinase

Question 10

() is activated as an oncogene by point mutations resulting in constitutive protein kinase activity in 90% of gastrointestinal stromal tumors

Answer 10

Kit

Question 11

(1) and (2) are small-molecule inhibitors of the EGF receptor that have shown activity against a subset of lung cancers in which EGF receptor is activated as an oncogene by point mutations

Answer 11

1. gefinitib
2. erlotinib

Question 12

sensitivity of tumors to inhibition of activated oncogene

Answer 12

oncogene addiction

Question 13

how can oncogene addiction be exploited in cancer treatment

Answer 13

• targeting the activity of the activated oncogene becomes much more important than focusing on the pathways that the cancer has affected
• in normal cells, alternative signaling pathways can compensate in one pathway is blocked

Question 14

effectiveness of many oncogene-targeted therapies is limited by the development of ()

Answer 14

resistance

Question 15

resistance can result from mutations in the (1), (2), and (3)

Answer 15

1. targeted kinase
2. activation of other tyrosine kinases
3. activation of downstream oncogenic pathways

Question 16

booster the immune response against cancer

Answer 16

immunotherapy

Question 17

one of the main strategies of immunotherapy involves genetic engineering to ()

Answer 17

create an enhanced immune response against tumor cells (e.g. targeting cancer surface cell receptors)

Question 18

blocking () of T cells has become an effective therapeutic strategy against cancer cells

Answer 18

down-regulaton

Question 19

T cells are normally regulated to prevent them from destroying normal tissues → but this ()

Answer 19

can hinder immune response against cancer cells

Question 20

() is expressed on T cell surfaces to regulate T cells by inducing apoptosis

Answer 20

PD1 (programmed cell death protein 1)

Question 21

T cells are genetically engineered to respond against a protein expressed by cancer cells

Answer 21

Car-T cell therapy

Question 22

in Car-T cell therapy, () is introduced into a patient’s T cells by viral infection

Answer 22

chimeric antigen receptor (CAR)