Cancer and Immunotherapy

Question 1

what is a driver mutation

Answer 1

a change in a gene/protein that gives a cancer cell a fundamental growth advantage for its neoplastic transformation

Question 2

what is a carcinoma

Answer 2

cancer derived form endoderm or ectoderm

Question 3

what is leukemia

Answer 3

cancer of the blood or bone marrow

Question 4

how is acute lymphocytic leukemia characterised

Answer 4

appearance of immature, abnormal B cell blasts

Question 5

clinical effects of acute lymphocytic leukemia

Answer 5

anaemia, low WBC, weight loss, fatigue. thrombocytopenia

Question 6

what are tumour associated antigens?

Answer 6

antigens derived from genes overexpressed in tumours, normal proteins minimally expressed by healthy tissues

Question 7

what are tumour specific antigens

Answer 7

antigens restricted to tumours not found in healthy cells

Question 8

what are oncofetal proteins

Answer 8

proteins normally expressed in fetal development not in adult tissue, re-expressed in some cancers

Question 9

what are neoantigens

Answer 9

protein antigens encoded by mutated household genes

Question 10

what are the products of mutated genes

Answer 10

chromosomal translocations
point mutations
neoantigens

Question 11

example of oncofetal proteins

Answer 11

a fetoprotein - liver cancer

CEA - colon cancer

Question 12

what are some oncogenic viruses

Answer 12

human T leukemia virus
EBV
HPV
Hep B and C

Question 13

what cancers are caused by EBV

Answer 13

burkitts lymphoma and nasopharyngeal cancer

Question 14

what cancer does hepatitis cause

Answer 14

liver cancer

Question 15

what is the principal mechanism of recognition of tumour cells

Answer 15

CD8 CTLs

Question 16

what do NK cells detect

Answer 16

decreased or lack of MHC class I

Question 17

mechanism of killing cancer cells

Answer 17

Apoptotic cell death by:
antibody - ADCC
CTL recognition of virus peptides
NK - loss of MHC

Question 18

what is anergy?

Answer 18

immunologic tolerance characterised by the failure to amount a full immune response to a tumour

Question 19

how is an immuno suppressive environment established in cancer

Answer 19

adenosine released to suppress T cell activation
down regulation of MHC class I- failure to present cancer antigens
down regulation of tumour markers
failure of APC to present antigen
failure of CTLs and NK cell to kill

Question 20

how is T cell activation repressed by tumours

Answer 20

adenosine released under hypoxic conditions

Question 21

what immuno suppressive cytokines are released by tumour cells

Answer 21

IL10

TGFB

Question 22

What are the new generation treatments for cancer

Answer 22

• monoclonal antibodies against cancer antigens
• cytokines - IL2, IF
• immune checkpoint inhibitors
• CART Cells
• cancer vaccines

Question 23

what is important for diagnostic typing of cancer cells

Answer 23

all blast cells express a variety of lineage specific antigens

Question 24

what are immune checkpoints

Answer 24

down regulate the response once an infection has been controlled

Question 25

what are CART cells

Answer 25

combines the specificity of antibodies and cytotoxic ability of t cells

Question 26

what are chimeric antigen receptors

Answer 26

molecules genetically engineered into a polyclonal T cell population - T cells recognise tumour antigens

Question 27

what are the challenges in treating solid tumours with CART cells

Answer 27

identifying precise tumour antigen
improving filtration into
overcoming immunosuppressive environment