Cancer 2) Hallmarks of cancer Flashcards

1
Q

Why is it important to study cancer?

A

1 in 3 people will develop cancer
1 in 4 men and 1 in 5 women will die of cancer
Incidence of cancer increases with age

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2
Q

What has studying cancer revealed?

A

Growth of normal cells
Pathways of controlling normal growth
Mechanisms of cell death
Mechanisms of tissue regeneration

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3
Q

What is the evidence that cancer is genetic?

A

Age evidence
Carcinogens are mutagens
DNA of tumours contains many and varied aberrations
Mutations in specific genes generate cells bearing hallmarks of cancer

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4
Q

What are the features of malignancy?

A

Uncontrolled growth
Capacity to infiltrate normal or damaged tissues
Capacity to spread to other sites
Capacity to cause illness and/or death

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5
Q

What are the cellular hallmarks of cancer?

A
Autonomy from growth signals
Evasion of growth inhibitory signals
Evasion of apoptosis
Unlimited replicative potential
Angiogenesis
Invasion and metastases
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6
Q

What cancer do viral HPV 16 and 18 cause?

A

Cervical cancer

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7
Q

What is the role of E6 and E7 proteins in cervical cancer?

A

Both required for carcinogenesis
E6 binds p53 and targets it for degradation
E7 binds, phosphorylates and inactivates Rb protein

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8
Q

What cancer does HTLV-1 cause?

A

Adult T-cell lymphoma

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9
Q

What virus causes Burkitt’s lymphoma?

A

EBV

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10
Q

What do UV radiation and chemical carcinogens do?

A

Interact with components of DNA to cause damage
Damage can be to bases or sugar-phosphate backbone
Damage can be repaired, misrepaired or unrepaired

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11
Q

What are oncogenes?

A

Mutated version of normal human proto-oncogenes

Dominant, not normally inherited

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12
Q

How can oncogenes affect gene function?

A

Increase level of expression of the gene
De-regulate expression of the gene
Alter protein product so it’s more active
Alter protein product so it’s not degraded

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13
Q

What do oncogenes do to malignant pathways?

A

Increase activity of pro-malignant pathways - cell growth, replication, angiogenesis, invasion, metasases
Inhibit activity of anti-malignant pathways - apoptosis, cell cycle regulation, growth inhibition

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14
Q

Give examples of oncogenes

A

erbB1
erbB2
ras

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15
Q

What does erbB1 encode and what do mutations do?

A

Encodes EGFR
Oncogenic mutation means EGFR is activated in absence of EGF
Causes overactivity of RAS-MAPK pathway and over expression of growth promoting genes

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16
Q

What does mutated ras cause?

A

Loss of GTP-ase activity of RAS protein

RAS remains bound to GTP and is constitutively activated

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17
Q

What are tumour suppressor genes?

A

Suppress pro-malignant processes: apoptosis, cell cycle checkpoints, growth inhibition, DNA repair

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18
Q

Give examples of tumour suppressor genes

A

p53
BRCA1 and BRCA2
APC

19
Q

What is the consequence of mutated p53?

A

Cells proceed to mitosis with damaged DNA
Cells fail to undergo apoptosis when damaged
Incomplete DNA repair
Tumour angiogenesis persists causing tumour growth

20
Q

What is Li-Fraumeni syndrome?

A

Inherited p53 mutation
Grossly elevated cancer risk
Causes sarcoma, breast cancer, leukaemia and brain tumours at early age

21
Q

Describe APC mutations

A

Inherited mutations responsible for familial adenomatous polyposis coli
1 mutation inherited, other is spontaneous mutation in colonic epithelium

22
Q

What is FAP?

A

Develop multiple colonic polyps in early adulthood which predispose to cancer
Very high risk of colon cancer

23
Q

Describe the chain of events leading to colorectal cancer

A
Normal colonic epithelium
APC mutation causes small adenoma
K-ras DCC mutation causes large adenoma
p53 mutation causes carcinoma
Aneuploidy causes metastases
24
Q

What do normal growth inhibitory signals do?

A

Downregulate growth receptors
Inhibit transcription
Inactivate or degrade signalling proteins
Phosphatases inhibit kinase signalling cascades
Compete with growth mediating proteins

25
What is the mechanism of apoptosis?
Cytoplasmic shrinkage Nuclear breakdown Cleavage of structural proteins Membrane blebbing, apoptotic bodies
26
How can apoptosis be activated?
Extrinsically e.g. in response to TNF or intrinsically in response to oxidative stress or DNA damage
27
Give an example of an anti-apoptotic protein
Bcl-2
28
Give examples of pro-apoptotic proteins
Bax | p53
29
What is the consequence of p53 mutation on apoptosis?
Renders cells less likely to undergo apoptosis Mutant cells are more likely to develop further mutations Mutant cells are more resistant to cancer treatment
30
How does cancer cause unlimited replicative potential?
Telomerase is unregulated which maintains length of telomeres and stops them shortening so they don't undergo cellular senescence or apoptosis
31
What is a stimulant of angiogenesis?
Vascular endothelial growth factor (VEGF) | Hypoxia
32
How do tumour cells break free from inter and extracellular connections?
Via abnormal expressions of integrins | Invasive capacity mediated by matrix metalloproteases and inhibited by TIMPs
33
What are the emerging hallmarks of cancer?
Deregulating cellular energetics Avoiding immune destruction Genome instability and mutation Tumour-promoting inflammation
34
What drugs are given to prevent proliferative signalling?
EGFR inhibitors
35
What drugs are given to stop evasion of growth suppressors?
Cyclin-dependent kinase inhibitors
36
What drugs are given to stop cancer avoiding immune destruction?
Immune-activating CTLA4 mAb
37
What drugs are given to stop cancer enabling replicative immortality?
Telomerase inhibitors
38
What drugs are given to stop tumour promoting inflammation?
selective anti-inflammatory drugs
39
What drugs are given to stop cancer activating invasion and metastases??
Imhibitors HGF/c-MET
40
What drugs are given to stop cancer inducing angiogenesis?
Inhibitors VEGF signalling
41
What drugs are given to stop genome instability and mutation?
PARP inhibitors
42
What drugs are given to stop cancer resisting cell death?
Propapoptotic BH3 mimetics
43
What drugs are given to stop cancer deregulating cellular energetics?
Aerobic glycolysis inhibitors