BL- TUMOR IMMUNOLOGY

Question 1

immunodeficiencies (esp T cells) have inc rate of tumors

e.g. AIDS patients have a higher rate of Kaposi sarcoma, Burkitt lymphoma, and some other tumors.

Answer 1

Evidence for cancer immune surveillance:

Question 2

Immune Surveillance

Answer 2

proposed in 1950 that the real role is to survey cells and kill abnormal guys, and this would kill cancer

Question 3

We can think about the role of the immune system in neoplastic development as a series of stages in a process that has been called _____

Answer 3

“immunoediting”

Question 4

Organ transplant recipients taking powerful immunosuppressive drugs had a 25 to 100-fold increase in tumors relative to healthy controls.

Answer 4

Evidence for cancer immune surveillance:

Question 5

If ____ are invading cancer, better prognosis

Answer 5

lymphocytes

Question 6

Nude mice (mice with no thymus) should get tumors very readily, but in fact spontaneous tumors are______

Answer 6

rare in these mice.

Question 7

People treated with chemotherapy may have a 14-fold increased risk of developing secondary leukemia.

Answer 7

Evidence for cancer immune surveillance:

Question 8

(NK) cells, which are not part of the traditional (T and B cell) immune system can:

Answer 8

tumoricidal

Question 9

immunoediting

Answer 9

role of the immune system in neoplastic development as a series of stages

Question 10

A small percentage of tumors, mainly melanomas and some lymphomas, spontaneously regress, presumably due to an immunologic response

Answer 10

Evidence for cancer immune surveillance:

Question 11

IMMUNOEDITING STEPS

Answer 11

Elimination- kill the bad guy
Equilibrium
Escape: the tumor cells fight back

Question 12

Driver mutation

Answer 12

a mutation that gives a selective advantage to a clone in its microenvironment, through either increasing its survival or reproduction.

creates cancer

Question 13

Activated T cells that recognize tumor-associated antigens can easily be identified.

The presence of lymphocytes in a tumor (tumor-infiltrating lymphocytes or TIL,) many of which are tumor-specific, is a good prognostic sign.

Answer 13

Evidence for cancer immune surveillance:

Question 14

lymphocytes infiltrate the tumor, but do not fully destroy it. Instead the tumor and lymphocytes exist in _______

Answer 14

Equilibrium

IMMUNOEDITING STEPS

Question 15

when a clone becomes malignant its most likely fate is to be recognized as abnormal by both the innate and adaptive immune systems, and thus ______

Answer 15

eliminated

((IMMUNOEDITING STEPS))

Question 16

tumors fight back when the immune system attacks them.

For example, it is common to find tumor-specific ______ surrounding tumor clusters in biopsies.

Answer 16

CTLs

Question 17

Becomes tumors are out of control and mutating a lot, the immune system may:

Answer 17

have a hard time keeping up

allows escape

Question 18

The tumor is invisible to the immune system or _____ it locally

Answer 18

suppress immune cells

leads to escape

Question 19

______ probably the most important cells in tumor resistance.

Answer 19

CD8+ T cells (CTL)

Question 20

Tumor Acs. Antigens

Answer 20

Different from normal cell by:

• over expression of normal Ag
• mutated

Question 21

Th1 cells- CD4+ T cells

Answer 21

recognize the tumor antigens, make lymphokines, and attract angry M1 macrophages

Question 22

Tumor rejection antigen

Answer 22

Antigen from a tumor that the immune system can “see”

Question 23

usually called LGLs (large granular lymphocytes).

part of innate immunity.

Answer 23

Natural Killer (NK) cells

Question 24

Cells need to see _____ to actually fight a tumor

Answer 24

Immuno-dominate epitope (if it exists, proposed)

Question 25

ONCOFETAL ANTIGENS

Answer 25

Fetus grows a lot, may turn on again in adulthood but CAN BE turned back on into a cancer

VERY high false positive in screening

Question 26

tumor-infiltrating lymphocytes (TIL)

Answer 26

Cells directly from the tumor

Question 27

This technology utilizes cells from the patient’s immune system to destroy cancerous cells that cannot be surgically removed.

Cells isolated from the patient’s blood, tumor, or lymph nodes.

Answer 27

Adoptive cell transfer therapy.

Question 28

DIFFERENTIATION ANTIGENS

Answer 28

Characteristic of a specific cancer
Monoclonal AB can target this and treat it
ex: HER-2/neu

Question 29

Natural mechanisms to kill tumor cells

Answer 29

• CTL
• Th1
• Macs
• NK
• ABs

Question 30

Vaccine to cancer

Answer 30

Every tumor is different, so making a vaccine is challenging

ex:
pts monocyte–> dendrytic cells–> soaked in prostate antigen –> used as vaccine

$$$

Question 31

QALY

Answer 31

Quality adjusted life year

Ins companies will pay 30,000 per QALY

Question 32

Innocent Bystander Cancer Rx

Answer 32

BCG (TB) is injected directly into the tumor.

A ferocious delayed-type hypersensitivity reaction to BCG ensues, and the tumor cells are killed as innocent bystanders.

treatment of choice for superficial bladder
carcinoma.

Question 33

Check point inhibitors

Answer 33

“Off button” for immune cells (lymphocytes)

T cells:
CTLA-4
PD-1

B cells: CD80/86

Tumors are rich in ligands for these things

Monoclonal ABs can target this