Cancer I & II: Lect 17 and 18 Flashcards

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1
Q

Cancers are of what origin?

A
  • manifestation of mutation, usually of somatic origin.
  • inherited in a mendelian fashion but may exhibit non-mendelian family clustering (multifactorial causation).
  • accumulation of genetic alterations.
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2
Q

Tumor progression;

A
  • normal > hyperplastic > dysplastic > neoplastic > metastatic.
  • result of clonal expansion
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3
Q

Malignant transformation:

A

Survival and growth

  • self sufficiency
  • insensitive to growth inhib signals
  • evades apoptosis
  • escape immune attack
  • limitless replicative potential

Metastasis

  • loss of contact inhib
  • loss of cell-cell adhesion
  • invades other tissues

Incr. mutation rate
-breakdown in DNA repair and genomic stability

Energy supply
-sustained angiogenesis

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4
Q

Are cancers derived from a single cell?

A
  • yes; monoclonal tumors.
    ex: 1. all cells from cancers have same copy of the X inactivated
    2. all cells in the tumor contain the abberration.
    3. multiple myelomas produce monoclonal Ig.
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5
Q

Multiple myeloma

A
  • malignancy of B-cell.

- all myeloma cells in a pt produce the same Ab mx. “evidence of monoclonality”

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6
Q

Cancer causing genes;

3 types

A

-imbalance of cell birth and cell death.

Oncogenes - stimulate growth.
Supressor genes - inhibit growth
Repair genes - limit mutations

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7
Q

Proto-oncogenes

A
  • produce proteins which promote cell growth or prevent apoptosis.
  • mutation/mis-expression = cell growth
  • gain of function mutation
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8
Q

Tumor suppressor genes

A
  • produce proteins that inhibit the cell cycle preventing proliferation
  • loss of function mutation
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9
Q

Mutations in DNA repair genes

A

-increase the frequency of mutations in cells.

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10
Q

Cellular growth control

A
  1. GF bind to GF rcp trk = autophosphrylation in cytoplasmic side.
  2. activation of GTPase proteins which activate TF in the nucleus.
  3. activate gene exp to drive DNA replication.
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11
Q

Oncogenes

A

-mutant or misregulated form of proto-oncogenes.

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12
Q

Transmembrane proteins:

Cytoplasmic:

Nuclear:

A
  • erbB, neu, fms, ras
  • abl
  • myc, fos, jun.
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13
Q

GF receptors:

G protein/signal transduction:

Intracellular tyrosine kinase:

Transcription factors:

A
  • c-erbB
  • c-ras
  • c-abl
  • c-myc, c-fos, c-jun
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14
Q

MAP Kinase pathway

A
  • cell prolif pathway
  • initiated by GF interacting w/ rcp
  • triggers activation of kinases = phos. of ser/thr residues.
  • activates gene driving cell division.
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15
Q

Tyrosine kinase rcp activation

A
  • receptor trk binds to ligand sites
  • dimerization and phosph. of activation lip tyrosines.
  • phos. of additional tyr. residues downstream.
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16
Q

What renders a receptor constitutively active?

A
  • Point mutations or truncation.

- rcp dimerizes w/o the signal and starts to activate downstream signals.

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17
Q

Oncogenically activate a receptor by?

A
  • Point mutation: single AA change w/o the presence of a GF. ex: Her2 rcp
  • Truncation/deletion: ErbB oncoprotein.
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18
Q

Oncogenic activation by translocations;

A
  • exchange of genetic material btwn non-homologous chrom “illegitimate recombination”
  • Burkitt lymphoma -> activation of myc
  • Chronic Myeloid Leukemia -> activation of abl.
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19
Q

Burkitt lymphoma

A
  • myc oncogene(chrom 8) is fused to Ig locus(chrom 14). (t8:14)
  • oncogene expression increases as myc is under regulation of IgH promoter = incr. myc production.
  • lymphocyte fail to differentiate
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20
Q

Bcr-Abl translocation and Chronic Myeloid Leukemia:

A
  • Philadelphia chrom t(9;22)

- abl on chrom9 fuses to bcr region of chrom22 = unregulated cytosolic trk so abl.

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21
Q

Gleevec/Imatinib mesylate

A
  • powerful trk inhibitor specific for a few TKs including Abl.
  • very effective against the BCR/ABL by binding to active site.
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22
Q

Point Mutations

A
  • activation of the Ras proto-oncogene

- Ras activated by binding GTP; initiates cell proliferation. It is inactivated by GTPase activity (GTP->GDP)

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23
Q

Oncogenic activation

A
  • depends on Ras hyper-activity.
  • Ras-GTP activates growth pathway
  • Ras-GDP inactive (no growth)
  • mutations inhibiting GTPase activity = Ras becomes constitutively active.
24
Q

Oncogenesis by gene amplification:

A
  • Double minutes

- Homogenously staining regions

25
Q

Double minutes

A
  • extrachromosomal fragments of DNA; not assoc. w/ the chrom
  • contain an amplified region of chrom
  • seen in tumors
  • EGFR; often amplified as double minute chrom
  • visualized w/ FISH probes
26
Q

HSR

A
  • withing the chrom in cancers often contain amplified oncogenes.
  • ex: N-MYC amplification in neuroblastomas
  • visualized w/ FISH
27
Q

Mutations in tumor suppressor genes:

A
  • Inherited AD cancer syndromes: recessive at cellular level but w/ loss of second copy.
  • Inherited AR cancer syndrome of defective DNA repair: XP, Ataxia telangiectasia, Bloom syndrome, Fanconi anemia.
  • Familial cancers: multifactorial cause breast/ovarian/pancreatic cancer.
  • role of predisposition not clear for each indiv.
28
Q

Tumor suppressor genes:

APC -

TP53 -

BRCA1/2 -

RB -

WT1 -

MSH1/2, PMS1/2 -

A

-Familial adenomatous polyposis; bowel carinoma.

  • Li-Fraumeni syndrome; soft tissue sarcoma, glioma, leukemia
  • Familial breast/ovarian cancer.
  • Retinoblastoma; schwannoma, menigioma, ependymoma.
  • WAGR (Wilms tumor, aniridia, GU anomalities, growth retardation)
  • Hereditary nonpolyposis colon cancer; colorectal carcinoma, endometrial carcinoma
29
Q

Wilms tumor:

A
  • AD inheritance
  • loss of function in the WT1 gene on chrom 11; which encodes TF important in the control of cell growth and differentiation.
30
Q

Tumor suppressor genes:

A
  • genes that cause cancer when they are lost “loss of function mutation”
  • nl function is to stop cancer
  • cell cycle control genes, apoptosis promoting genes, DNA repair genes.
  • must loss function of both gene to get cancer = two hits
31
Q

Two-hit hypothesis:

Familial form:

Non-familial (sporadic):

A
  • 1st mutation from inherited from mom/dad and present in every cell.
  • 2nd occurs in somatic cell = cancer; loss of tumor sup
  • earlier and more severe than sporadic.
  • multiple/bilateral tumors.
  • not born w/ the mutation
  • 1st hit during cell division = no cancer.
  • 2nd hit later in life = cancer
  • two somatic mutations that result in cancer = loss of all tumor suppressor activity.
32
Q

Loss of Heterozygosity:

A
  • seen in tumor suppressor mutations
  • homozygous parent at locus (1 or 2)
  • child is heterozygous (1 and 2)
  • tumor tissue has a single allele type (2) so loss of allele 1 = LOH
33
Q

Mechanisms producing 2nd hit:

A
  • loss through non-disjunction
  • mitotic recombination
  • gene deletion
  • point mutation
34
Q

Loss of Tumor suppressor gene function:

A
  • result of aberrant methylation = gene still present but silenced.
  • mutations in DNA silencing mechanisms can result in tumors.
    ex: methylation of Rb (90% penetrance)
35
Q

Rb protein:

w/ cyclin/Cdk and without??

A
  • regulator of G1/S phase transition.
  • –cyclin/Cdk present = Rb hyperphos. = Rb no longer represses E2Fs = E2Fs activate S-phase genes = cell divides.

—no cyclin/Cdk = hypophos of Rb = Rb/E2F complex bound to DNA = recruit histone MT and HDAC = no transcription.

36
Q

What happens when Rb is mutated?

A
  • mutant Rb = hyperphos Rb = cell division and no G1 arrest.
  • inactivation of Rb is critical in driving G1/S transition.
37
Q

Mutations of one of four genes that regulate the phos. of Rb?

A
  • Rb: inhibitor of E2F
  • CDK4: inactivates Rb by phos.
  • Cyclin D: inactivates Rb by phos.
  • CDKN2A(p16): CDK inhib
38
Q

Retinoblastoma:

Inherited;

Sporadic;

A
  • childhood cancer; AD inheritance but recessive at cellular level
  • mutation of Rb gene on chrom 13.
  • 30-40% of Rb w/ 90% penetrance. Multiple/bilat tumors and early onset. 1 germline and 1 somatic mutation.

-60-70% of Rb. Single/unilat tumors and later onset. 2 somatic mutations = 2 hits.

39
Q

Loss of Rb/mutant Rb:

A
  • destroys the G1/S chkpt.

- does NOT bind to E2F -> increased transcription of S phase genes.

40
Q

p53

A
  • tumor sup. that controls both cell birth and cell death
  • TF activated by cell stress/DNA damage which impinges on G1/S chkpt.
  • mutated in 50% of all cancers.
41
Q

Roles of ATM and ATR in signaling through the G1 chkpt?

A

-DNA double strand breaks induces ATR and ATM to act on p53 causing G1 arrest or apoptosis.

42
Q

p53 duties?

A
  1. slows cell cycle and allows time to do repairs.
  2. increase DNA repair capabilities.
  3. too much damage; initiates apoptosis via Bcl-2 fam members.
  4. has anti-angiogenic proteins.
43
Q

p53 influences apoptosis by increasing expression of:

A
  1. pro-apoptotic Bcl-2 family members
  2. Fas receptor (CD95)
  3. IGFBP-3
44
Q

Li-Fraumeni syndrome:

A
  • inherited mutation in p53.
  • increases risk of cancer at young age/high penetrance
  • results in several kinds of cancer; breast, bone, brain, adrenocortical and soft-tissue carcinomas “affects multiple organs”
  • 1st hit from parent
  • 2nd hit is somatic (Loss of H)
45
Q

Colorectal cancers:

Familial Adenomatous Polyposis.

A
  • gatekeeper/tumsup protein involved
  • AD inheritance
  • mutation in the APC gene on chrom5 & allelic heterogeneity
  • multiple >100 adenomatous polyps develop in distal colon.
  • slow progression
  • high penetrance
46
Q

APC pathway: WNT present

A

-encodes a tumor sup whose role is to down-regulate growth promoting signals.

  • When WNT is present, no APC/B-catenin complex; so B-catenin is not degraded.
  • B-catenin moves to the nucleus and forms complex w/ TCF-4 = growth promoting genes.
47
Q

APC pathway: WNT absent

A
  • no signal for growth
  • APC interacts w/ B-catenin; phos and ubiquinates B-cat
  • B-cat is degraded = no complex w/ TCF-4 = no growth.
48
Q

APC mutation?

A
  • mutant APC does not interact w/ B-cat in the absence of WNT signal
  • B-cat not phos and degraded
  • B-cat interacts w/ TCF-4 = growth in abs of WNT.
49
Q

Hereditary Non-Polyposis Colon Cancer: Lynch syndrome

A
  • caretakers/DNA repair proteins involved.
  • mutation of DNA mismatch repair (MMR) genes.
  • MSH2 chrom 2; 60% of known mutations
  • MLH1 chrom 3, 30-35% of known mutations.
  • locus heterogeneity
  • tumor exhibits microsatellite instability (short repetitive seq)
  • few polyps and progress rapidly
50
Q

Breast/Ovarian Cancer:

A
  • 20% familial hx
  • penetrance 85% for breast and 55% (BRCA1) or 25% (BRCA2) for ovarian cancer.
  • BRCA1/2 = Locus heterog.
  • involved in DNA repair or apoptosis
  • loss of BRCA1, cell duplicate w/ DNA damage = cancer
  • 100s of mutations in BRCA1 gene = Allelic het.
51
Q

HER2 overexpression in sporadic breast cancer;

A
  • Human epidermal growth factor rcp 2
  • 30% of breast cancers have HER2 amplified
  • form double minutes chrom
52
Q

Herceptin:

A
  • Ab to HER2
  • binds to HER2 and prevents bind of EGF to HER2
  • decreases tumor proliferation
  • very effective for Her2+; not as effective for Her2- tumors.
53
Q

Epigenetics in tumors and roles?

A
  • tumor sup. loci are frequently hypermethylated in cancer “silenced”
    1. silencing of tumor sup = overgrowth
    2. loss of imprinting = activation of growth assoc. genes (IGF2)
    3. MicroRNAs
54
Q

MicroRNAs in tumors

A

-miRNAs act to reduce the expression of genes by targeting specific mRNAs.

55
Q

Expression array analysis and cancer

A
  • cancer classification
  • in order to determine; rate of prolif, invasion capacity, metastases potential.
  • determine changes in expression of large number of genes btwn two groups (tumor vs. non tumor, benign vs. malignant)