Biopharmaceuticals in Oncology

Question 1

What is cancer?

Answer 1

A disease caused by the loss of regulation in cell division, leading to uncontrolled growth.

Question 2

What are the main types of cancer? (6)

Answer 2

• Sarcoma (mesenchymal tissues)
• Carcinoma (epithelial tissues)
• Adenocarcinoma (glands)
• Lymphoma (lymphoid tissues)
• Leukaemia (blood/marrow)
• Teratoma (complex tumours)

Question 3

What are the TWO main factors that contribute to cancer?

Answer 3

Nature (genetics) and Nurture (environment & epigenetics).

Question 4

Why are humans highly susceptible to cancer?

Answer 4

Due to a hyper-mutable genome, making us prone to mutations.

Question 5

How do cancer rates vary? (6)

Answer 5

By age, ethnicity, and geographic location, influenced by genetics, diet, and environment.

Question 6

What is the main cause of cancer-related deaths?

Answer 6

Metastasis – the spread of cancer to distant organs.

Question 7

Why is early detection of cancer critical?

Answer 7

It increases survival rates by allowing for earlier and more effective treatment.

Question 8

What is the role of kinases in cancer?

Answer 8

Kinases, such as RAS, regulate cell growth and can become overactive in cancer.

Question 9

What is the function of p53 in cancer suppression?

Answer 9

p53 is a tumor suppressor protein that regulates DNA repair, apoptosis, and cell cycle control.

Question 10

How do genetic mutations contribute to cancer?

Answer 10

They alter cell signaling pathways, leading to uncontrolled cell division and survival.

Question 11

What are biopharmaceuticals?

Answer 11

Drugs derived from biological sources, including monoclonal antibodies and targeted therapies.

Question 12

How do biopharmaceuticals treat cancer?

Answer 12

They target specific cancer-related pathways, reducing side effects compared to chemotherapy.

Question 13

What is an example of a biopharmaceutical used in cancer treatment?

Answer 13

Monoclonal antibodies (e.g., trastuzumab for HER2+ breast cancer).

Question 14

What are the advantages of biopharmaceuticals over traditional chemotherapy? (3)

Answer 14

• Higher specificity for cancer cells
• Reduced side effects
• Targeted therapy approach

Question 15

How do epigenetic changes contribute to cancer?

Answer 15

They alter gene expression without changing DNA sequence, leading to tumor progression or suppression.

Question 16

What are the SIX types of epigenetic therapy targets?

Answer 16

• Writers – Add modifications
• Erasers – Remove modifications
• Readers – Detect modifications
• Movers – Shift histone modifications
• Shapers – Alter histone function
• Insulators – Prevent boundary loss

Question 17

How many epigenetic therapies are FDA-approved? (number + 3 examples)

Answer 17

Nine epigenetic agents in the U.S., including DNMT inhibitors, HDAC inhibitors, and EZH2 inhibitors.

Question 18

Why are epigenetic therapies promising?

Answer 18

They can reverse abnormal gene expression patterns in cancer cells.

Question 19

What is the best strategy to reduce cancer mortality?

Answer 19

Early detection combined with targeted treatments and lifestyle changes.

Question 20

Why is there no universal cure for cancer?

Answer 20

Because each cancer is genetically and epigenetically unique, making broad treatments ineffective.

Question 21

What are the key targets for cancer therapy? (5)

Answer 21

• Viral genome elements
• Proto-oncogenes
• Growth activation pathways
• Hyper-mutation mechanisms
• Stem cell derived cancers

Question 22

How do vaccines help in cancer prevention?

Answer 22

They target cancer-related viruses. (e.g., HPV vaccine for cervical cancer)

Question 23

What are TWO main types of cancer treatment targets?

Answer 23

• Intracellular (kinases, division pathways).
• Extracellular (antibodies, aptamers, effector delivery).

Question 24

How do kinases contribute to cancer?

Answer 24

Activating mutations or chromosomal alterations lead to uncontrolled kinase activity, promoting tumour growth.

Question 25

Why are "dirty drugs" often preferred over highly selective inhibitors?

Answer 25

Broad inhibitors reduce compensatory mutations and delay treatment resistance.

Question 26

How do small molecule kinase inhibitors work? (4)

Answer 26

They block kinase activation, preventing tumour cell survival, proliferation, and angiogenesis.

Question 27

What are the FOUR main categories of traditional chemotherapy drugs?

Answer 27

1. Alkylating agents 2. Anti-metabolites 3. Anti-microtubule agents 4. Antibiotics

Question 28

What is a monoclonal antibody? (easy)

Answer 28

A lab-created antibody that specifically targets cancer cell surface antigens.

Question 29

Name THREE commonly used MABs in cancer therapy.

Answer 29

1. Rituximab 2. Bevacizumab 3. Trastuzumab

Question 30

How do MABs target cancer? (3)

Answer 30

They induce apoptosis, block angiogenesis, or recruit immune system cells.

Question 31

What are the limitations of MAB therapy? (3)

Answer 31

High dosing requirements, off-target effects, and difficulty in identifying tumour-specific antigens.

Question 32

What is CAR T-cell therapy?

Answer 32

A personalised cancer treatment where T-cells are genetically engineered to target cancer cells.

Question 33

What are the risks of CAR T-cell therapy? (3)

Answer 33

1. Severe immune reactions 2. Cytokine storms 3. High treatment costs

Question 34

What is a checkpoint inhibitor in cancer therapy?

Answer 34

A drug that blocks immune checkpoints (e.g., PD-1, CTLA-4) to enhance immune response against cancer.

Question 35

How do cancer cells evade the immune system?

Answer 35

By exploiting checkpoint proteins to suppress immune attack.

Question 36

What was the major issue with the TGN1412 trial?

Answer 36

It caused a cytokine storm, leading to severe inflammation and organ failure in patients.

Question 37

What are cancer vaccines challenging to develop?

Answer 37

Tumour mutate and develop alternative antigens to escape immune detection.

Question 38

How does CD47-deficient tumour cell vaccination work?

Answer 38

It removes an immune evasion signal, allowing the immune system to attack cancer cells

Question 39

What is CRISPR's potential role in cancer therapy?

Answer 39

It can edit oncogenic mutations and enhance immune-cell based therapies/

Question 40

How does the stem cell cancer hypothesis explain tumour growth?

Answer 40

Some cancers originate from mutated stem cells with high renewal capacity.

Question 41

Why is combination therapy important in cancer treatment?

Answer 41

It reduces resistance by targeting multiple cancer survival mechanisms.

Question 42

What are TWO key challenges of cancer immunotherapy?

Answer 42

Balancing immune activation and preventing excessive inflammation

Question 43

How do small molecules and monoclonal antibodies complement each other in therapy?

Answer 43

Small molecules target intracellular pathways, while antibodies act on cell surface antigens.

Question 44

Why is cancer no longer considered an immediate death sentence?

Answer 44

Advances in biopharmaceuticals have transformed it into a manageable chronic disease.