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EXMD 504 Biology of Cancer > Cancer Immunology > Flashcards

Cancer Immunology Flashcards

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1
Q

The three concepts of tumor immunology are ______________, cancer _______________ and tumor ______________

A

Immunosurveillance; immunotherapy; markers

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2
Q

Immunosurveillance also comprises observing the role of the immune status of the patient in cancer _________, _____________, growth and dissemination

A

Initiation; promotion

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3
Q

The two types of tumor markers are tumor-_____________ and tumor-_________________

A

Specific; associated

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4
Q

The basis of tumor immunology is to take a ____________ or inbred mice and inject them with a tumor ____________ or chemical carcinogen. Once the tumor grows, it is taken out of the mice before ______________ and broken up into small pieces

A

Syngeneic; virus; spreading

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5
Q

Thr process of introducing a tumor to mice and observing tumor rejection is called ________

A

TSTA (Tumor-specific transplantation antigens)

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6
Q

Which mouse between the donor and the sibling survives the TSTA procedure?

A

The sibling

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7
Q

Putative means generally _______________ or reputed to be

A

Considered

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8
Q

How was Coley’s toxin discovered?

A

After he had seen tumor regression in patients with erysipelas near head and neck cancers

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9
Q

Coley’s toxin was a mixture of ________________ bacteria that he injected directly into the tumors of patients with ________ and ________ cancer

A

Attenuated; head; neck

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10
Q

What are the components of the mixture of attenuated bacteria?

A

Serratia marcescens and Group A Strep. pyogenes

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11
Q

What are four techniques of immunotherapy?

A

Cancer vaccines, humoral antibodies, proinflammatory cytokines, checkpoint inhibitor blockade

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12
Q

Cell-based therapies are also known as ______________

A

Vaccines

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13
Q

Cancer vaccines involve the exposure of a patient’s own ___________ and _____________ cells to her tumor cells after ______________ of that tumor at surgery

A

Lymphocytes; dendritic; removal

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14
Q

What was hoped from exposing the immune cells to the tumor?

A

It would stimulate and expand the already putatively cancer-activated dendritic and/or T lymphocytes

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15
Q

What was the result of re-infusing the cancer-activated cells back into the patient?

A

Regression of the tumor

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16
Q

Which cancer vaccine has been used for the treatment of prostate cancer?

A

Dendreon’s Provenge

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17
Q

Who won the Nobel Prize for their studies of monoclonal antibody technology?

A

Kohler and Milstein

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18
Q

_________________ is used in the treatment of patients with HER2-______________ breast cancers

A

Herceptin; positive

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19
Q

________________ is a monoclonal anti-B (CD20) lymphocyte antibody that has been used for the treatment of B-cell ________________

A

Rituximab; leukemias

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20
Q

What is the role of proinflammatory cytokines in the activated anti-cancer immune T lymphocyte populations?

A

They expand the cell population

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21
Q

Which proinflammatory cytokines have been employed?

A

INF-alpha, TNF and IL2

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22
Q

Which approach is beneficial in avoiding the adverse side effects of in vivo cytokine therapy?

A

In vitro

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23
Q

Was tumor regression seen with proinflammatory cytokines?

A

Yes

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24
Q

A specific response continues for a finite period of time until _______________ inhibitors arise that effectively ____________ the progression of the immune response

A

Checkpoint; stops

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25
Q

What are the two major inhibitor molecules of the immune system?

A

CTLA4 and PD1

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26
Q

CTLA4 and PD1 intefere with the activation linkage that occurs between __________________ cells and ___________-positive helper _______ cells that initiate immune reactivity

A

Dendritic; CD4; T

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27
Q

What is the consequence of having monoclonal antibodies against CTLA4 and PD1?

A

The anti-tumor immune response can move forward without inhibition

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28
Q

MHCII is found on the ____________ cells and hold the tumor antigen to the ____________ cell

A

Dendritic; T

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29
Q

Co-receptor is between _____________ and ____________, required for immune response

A

B7; CD28

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30
Q

Which of the following lead to T-cell activation?
a) Co-stimulation via CD28
b) Ipilimumab blocks CTLA4
c) CTLA4 blocks co-stimulation

A

a and c

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31
Q

The bispecific T-cell engager binds to the tumor ____________ on the tumor cell and ___________ on the T cell

A

Antigen; CD3

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32
Q

What are engineered CAR T cells?

A

Chimeric antigen receptor T cells that can bind to the tumor antigen and kill the tumor cell

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33
Q

What was the result of the poliovirus cancer treatment?

A

PVS-RIPO infects glioblastoma tumors through CD155/Necl5 binding, signaling the immune system to destroy the tumor

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34
Q

What are the three types of tumor markers?

A

Out of place, out of whack, out of time

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35
Q

Associate the following tumor markers to their category:
a) ACTH
b) BCR-ABL
c) CEA
d) M peak of multiple myeloma/Bence-Jones proteinuria

A

a) out of place
b) out of place
c) out of time
d) out of whack

36
Q

Tumor-specific antigens appear on the _____________ of most and perhaps all _____________ cells as a consequence of the malignant transformation

A

Surface; cancer

37
Q

True or false: tumor-specific antigens should elicit an immune response

A

True

38
Q

What was the problem with the conclusion that tumor-associated and tumor-specific materials were likely to never be found?

A

Immunologic technology had just entered the field of cancer research and the work had been done in questionable manners

39
Q

What were the deficiencies in early immunologic studies?

A

Lack of adequate control tissue leading to the inability to differentiate tumor-specific from individual-specific antigens
Production of antitumor antisera by only one technique
Only one or two procedures were employed for the demonstration of tumor-specific antigens

40
Q

What are the three ways that the deficiencies were corrected?

A

The study of colorectal cancers where both tumor and normal tissue come from the same patient
The production of antitumor antisera by the use of either immunologic tolerance or absorption
The use of multiple procedures to detect antitumor antibodies

41
Q

What is involved in the tolerance technique?

A

Inject rabbit with extract of normal human colon tissue from the donor
Inject rabbit with extract of tumor human colon tissue from the donor
Formation of tumor-specific antiserum

42
Q

What is involved in the absorption technique?

A

Inject rabbit with extract of tumor human colon tissue from the donor
Mix extract of normal human colon tissue from the donor with the antitumor antiserum from the rabbit
Formation of tumor-specific antiserum

43
Q

Which primary cancers were positive for tumor-specific antibody?

A

GI tract endoderm, from lower 1/3 esophagus to anorectal junction

44
Q

Which cancers were negative for tumor-specific antibody?

A

Other organs other than GI tract

45
Q

It is the site of _____________ and not the site of ________________ that determined the expression of the entity in question

A

Origin; growth

46
Q

Why was carcinoembryonic antigen (CEA) the name given to the molecule in question?

A

The same constituent was found in fetal and embryonic gut in the first two trimesters of gestation

47
Q

Why is CEA tumor-associated and not tumor-specific?

A

It is present in small amounts

48
Q

CEA has a molecular mass of ___________ kD. Carbohydrate side chains constitute over 50% of the molecular mass, with 28 potential _____________ glycosylation sites

A

180; N-linked

49
Q

CEA is anchored to the ________________ rather than transmembrane in nature

A

Membrane

50
Q

What was the consensus conference on CEA epitopes?

A

Nine major epitopes of either peptide or glycopeptide structure were found
CEA is one of a family of molecules (CEACAM)

51
Q

How many domains are found in CEA?

A

Three

52
Q

What is the primary function of CEA?

A

Intercellular adhesion, stem cell maturation, bacterial cell surfaces
Function in metastasis

53
Q

What was shown from the radioimmunoassay of CEA?

A

CEA is less than 10 ng/ml in normal tissues, more than 10 is a problem
CEA was found in 70% of human cancers

54
Q

CEA is not a ________________ test since elevated, but _______________ blood levels may be found in a variety of inflammatory states

A

Screening; stable

55
Q

What are the ASCO guidelines useful for in regards to colorectal cancer?

A

Guide for pre-op staging, surgical planning and chemotherapy

56
Q

The National Comprehensive Cancer Network determined that pre-operative CEA level is a predictor of subsequent _____________ interval and the pattern of CEA decline post-op is an indicator for the need of adjuvant ______________

A

Disease-free; chemotherapy

57
Q

The WHO coined CEA as an independent ______________ factor

A

Prognostic

58
Q

Name one of the ways that CEA is used as a target

A

Radioactive monoclonal anti-CEA therapy
Pentacea in lung cancer
Vaccinia virus
Anti-CEA antibody directed enzyme prodrug therapy

59
Q

Cancer diagnosis is the integration of _____________ and _______________ features with a ____________________ assessment by biopsy or related technique

A

Clinical; imaging; pathological

60
Q

What are some clinically used tumor markers?

A

CEA, hCG, monoclonal Ig

61
Q

A mass is a ______________ or diffuse enlargement

A

Swelling

62
Q

What is the color of a mass?

A

White or pale

63
Q

What are the secondary changes to a mass?

A

Ulceration, bleeding, necrosis

64
Q

Link the following procedures to either cytologic methods or biopsy/histopathology methods in tissue diagnosis:
a) Resection
b) Analysis of fluids
c) Direct smears
d) Variable biopsies

A

a) Biopsy/histopathology methods
b) Cytologic methods
c) Cytologic methods
d) Biopsy/histopathology methods

65
Q

This technique establishes rapid diagnosis, mostly intra-operatively

A

Quick frozen section

66
Q

Tissue is quick frozen in ____________ and prepared for _______________

A

Cryostat; microscope

67
Q

What are the benefits of using quick frozen section?

A

Determining the nature of the lesion
Evaluating the margins of an excised tumor
Deciding additional studies other than histology

68
Q

What are four ancillary pathologic diagnostic techniques?

A

Immunohistochemistry, flow cytometry, circulating tumor cells, molecular/cytogenetic analyses (FISH, PCR, etc.)

69
Q

IHC is a marker for ______________ and _______________ receptors

A

Estrogen; progesterone

70
Q

Molecular/cytogenetic analyses in neoplasm provide _____________ and _____________ of malignant neoplasms, the detection of ______________ _______________ disease and the diagnosis of _____________ ________________ to cancer

A

Diagnosis; prognosis; minimal residual; hereditary predisposition

71
Q

Molecular/cytogenetic analyses are a __________ therapy with oncoprotein-directed ____________

A

Guiding; drugs

72
Q

What are the parameters to determine how well poorly a patient with cancer will do?

A

Grading and staging

73
Q

Grading refers to the degree of __________________

A

Differentiation

74
Q

A low grade symbolizes ___________ differentiated cells that are ______________ resembling to parent tissue

A

Well; closest

75
Q

Grading is done by ______________ __________________ based on _______________ and ___________________

A

Light microscopy; cytology; histology

76
Q

True or false: Grading schemes are organ-specific

A

True

77
Q

What are the characteristics of the Nottingham grading system for breast carcinoma?

A

Tubule formation (higher # linked to grade 1)
Mitotic count (higher mitoses/HPF linked to grade 3)
Nuclear pleomorphism (vesicular nuclei and large nucleoli linked to grade 3)

78
Q

The Nottingham grading system is used for ___________ carcinoma and the Gleason grading system is used for ______________ adenocarcinoma

A

Breast; prostate

79
Q

Staging of malignant neoplasms is the extent of a malignant neoplasm, of ______________ clinical value than grading

A

Greater

80
Q

Staging is done by examination of a _____________ surgical specimen and _____________ of other information

A

Resected; integration

81
Q

Associate each letter of the TNM system to the following traits:
a) Distant metastases
b) Primary tumor characteristics
c) Regional lymph node involvement

A

a) M
b) T
c) N

82
Q

How many stages are there for each category of the TNM staging process?

A

T: 6
N: 4
M: 2

83
Q

What are some of the goals of cancer treatment?

A

Curative, debulking, adjuvant, pallative

84
Q

What are some modalities of cancer treatment?

A

Surgery, radiation therapy, chemotherapy, immunotherapy, targeted molecular therapy

85
Q
A

EXMD 504 Biology of Cancer (11 decks)

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