302 Cancer biology: metastasis and prognosis Flashcards
What are some different types of colorectal cancer?
-Colon cancer
-Rectal cancer
-Oligometastatic disease
-Widespread metastatic disease
What is an adenocarcinoma?
Malignant transformation of glandular epithelium
What is Familial Adenomatosis Polyposis Coli?
inherited loss of APC, inevitable second hit > multiple polyps (hundreds) > inevitable subsequent driver mutations > cancer
What is Hereditary Non-Polyposis Colon Cancer (HNPCC)?
An inherited mutation in one of the genes involved with mismatch repair > multiple point mutations > increased risk of CRC, endometrial, small bowel and pancreatic cancers
What cellular dysfunctions are commonly present in colorectal cancer?
RAS/RAF/MEK/ERK or PI3 Kinase signalling
Activating mutations in K-RAS occur in approx 40% CRC, especially in polyp > cancer progression and left sided / rectal cancers
How is colorectal cancer treated with different mutations?
Chemoinnunotherapy
Cetuximab – anti EGFR antibody (but ineffective if KRAS mutation)
Encorafinib – blocks mutant BRAF – in combination with Cetuximab appears to control disease
Immune checkpoint inhibitors (that unmask cancer cells for immune clearance) now licensed in MMR deficient CRC (but ineffective in MMR proficient tumours)