Cancer Immunology Flashcards
Cancer and the immune system
Problem: immune system is taught to be self-tolerant
- ____ (thymus)
- __ ____ education (MHC-1)
Can the immune system distinguish normal healthy cells from malignant host cells?
- Yes it can
- Process is known as i____
Cancer and the immune system
Problem: immune system is taught to be self-tolerant
- T cells (thymus)
- NK cell education (MHC-1)
Can the immune system distinguish normal healthy cells from malignant host cells?
- Yes it can
- Process is known as immunosurveillance
Evidence for anti-tumour immunity
Clinical observations point ot existence of tumour-protective immunity in humans
- Lymphoid infiltration of cancers e.g. ‘hot’ vs ‘cold’ tumour
- type, location, density
- >‘immunoscore’, >prognosis
- >response to immunotherapy (pre-existing immune response to tumour)
Elaborate on all
Evidence for anti-tumour immunity
Clinical observations point ot existence of tumour-protective immunity in humans
- Lymphoid infiltration of cancers e.g. ‘hot’ vs ‘cold’ tumour
- type, location, density
- >‘immunoscore’, >prognosis
- >response to immunotherapy (pre-existing immune response to tumour)
- Measures density of two lymphocyte populations (CD3 and CD8) in the centre and periphery of tumor
- Score ranging from I0 (low densities of both cell types) to I4 (high densitites of both cell types)
- High immunoscore has better prognosis, longer term disease-free survival
- High immunoscore associated with a significantly improved response to immune checkpoint inhibition (immunotherapy) in terms of increased overall survival
Evidence for anti-tumour immunity
Clinical observations point ot existence of tumour-protective immunity in humans
- Immunodeficiency/immunosuppression
* primary (inherited) immunodeficiencies
* infection
* transplantation
- Immunodeficiency/immunosuppression
Elaborate on all
Evidence for anti-tumour immunity
Clinical observations point ot existence of tumour-protective immunity in humans
- Immunodeficiency/immunosuppression
* primary (inherited) immunodeficiencies- lymphoma - EBV
* infection - Malaria - Burkitt’s lymphoma - EBV
- AIDS - Karposi’s sarcoma - EBV
* transplantation - Kidney transplant (relative risk) - Karposi’s sarcoma - 50-100% relative risk
- lymphoma - EBV
- Immunodeficiency/immunosuppression
- .
- .
- Immunosuppression increases risk of virally induced cancer
- e.g. Malaria causes immunodeficiency - results in Burkitt’s Lymphoma - EBV
- In all forms of immunodeficiency, the relative risk of developing tumours in which oncogenic viruses are known to play a role is greatly increased
- Relative risk for kidney transplantation patients greatly increased because of wide regimen of immunsuppressive treatments
*
Evidence for anti-tumour immunity
Clinical observations point ot existence of tumour-protective immunity in humans
- In vitro immune response to cancer cells
* natural killer cells
- In vitro immune response to cancer cells
Elaborate on all
Evidence for anti-tumour immunity
Clinical observations point ot existence of tumour-protective immunity in humans
- In vitro immune response to cancer cells
* natural killer cells
* Spontaneous lymphocyte-mediated cytotoxicity (SLMC)
* From normal donors aganst recipient tumour
4.
- In vitro immune response to cancer cells
Evidence for anti-tumour immunity
Clinical observations point ot existence of tumour-protective immunity in humans
- Immune repsonse to cancer cells in animal models (in vivo)
- RAG -/- mice (lack B and T cells) develop more gut epithelial and breast tumours
- mice can be immunised to tumour cells
- Immune repsonse to cancer cells in animal models (in vivo)
Elaborate on all
Evidence for anti-tumour immunity
Clinical observations point ot existence of tumour-protective immunity in humans
- Immune repsonse to cancer cells in animal models (in vivo)
- RAG -/- mice (lack B and T cells) develop more gut epithelial and breast tumours
- mice can be immunised to tumour cells
- (direct evidence for tumour immunity)
- Immune repsonse to cancer cells in animal models (in vivo)
Evidence for anti-tumour immunity
Clinical observations point ot existence of tumour-protective immunity in humans
- Lymphoid infiltration of cancers e.g. ‘hot’ vs ‘cold’ tumour
- type, location, density
- >‘immunoscore’, >prognosis
- >response to immunotherapy (pre-existing immune response to tumour)
- Immunodeficiency/immunosuppression
- primary (inherited) immunodeficiencies
- infection
- transplantation
- In vitro immune response to cancer cells
- natural killer cells
- Immune repsonse to cancer cells in animal models (in vivo)
- RAG -/- mice (lack B and T cells) develop more gut epithelial and breast tumours
- mice can be immunised to tumour cells
ALL THESE EXPERIMENTS SHOW THE IMMUNE SYSTEM CAN R___ AND R___ TO T___ CELLS (A____)
Evidence for anti-tumour immunity
Clinical observations point ot existence of tumour-protective immunity in humans
ALL THESE EXPERIMENTS SHOW THE IMMUNE SYSTEM CAN RECOGNISE AND RESPOND TO TUMOUR CELLS (ANTIGENS)
Tumour antigens
LOTS of different classes of tumour antigens:
- O___ v___ antiens
- M___ g___ products
- A___ glycol___/glycop____
- A____ e____ antigens
- Cell-type s____ d_____ antigens
Q) foreign/mutated/unmutated for each?
Tumour antigens
LOTS of different classes of tumour antigens:
- Oncogenic viral antiens
- foreign
- Mutated gene products
- Mutated
- Altered glycolipid/glycoproteins
- Mutated
- Abberantly expressed antigens
- unmutated
- Cell-type specific differentiation antigens
- unmutated
- Oncogenic virus antigens
- Human papilloma virus (HPV16) e.g. E_ & E_
- C___ and a___ cancer, O__ cancer
- Epstein Barr Virus e.g. ___1
- B___ L___
- Foreign - i_____
- E7 induces i_____ e.g. MHC Class I suppression, represses ___, ___ genes
- EBNA1 G__-A__ repeates inhibit p____/Ag presentation
- Oncogenic virus antigens
- Human papilloma virus (HPV16) e.g. E6 & E7
- Cervical and anal cancer, Oral cancer
- Epstein Barr Virus e.g. EBNA1
- Burkitt’s Lymphoma
- Foreign - immunogenic
- E7 induces immunosuppression e.g. MHC Class I suppression, represses TLR9, IRF genes
- EBNA1 Gly-Ala repeates inhibit proteasome/Ag presentation
- Mutated Gene Products
- Cancer cells can have lots of mutations
- Oncogenes and TSGs frequently mutated in cancer
- good example:____
- Intron retention in mRNA due to dysregulated splicing in cancer cells e.g. melanoma
- These are ‘altered self’ and can be immunogenic
- Tumour-specific neoepitopes may be therapeutic targets in personalised cancer vaccines
- Majority of protective immune responses - highly speciifc for cancer cells vs. host cells
2 key takeaways:
- Mutational load is highly ____, of which melanoma is _____
- Cancers cells are inherently _____, can generate lots of _______ to _______
- Mutated Gene Products
- Cancer cells can have lots of mutations
- Oncogenes and TSGs frequently mutated in cancer
- good example: tumour infilrating cd4+ cells specific for BRAF mutation in melanoma correlate with complete clincal response in these patients
- Intron retention in mRNA due to dysregulated splicing in cancer cells e.g. melanoma
- These are ‘altered self’ and can be immunogenic
- Tumour-specific neoepitopes may be therapeutic targets in personalised cancer vaccines
- Majority of protective immune responses - highly speciifc for cancer cells vs. host cells
- figure shows frequency of mutations per megabase of human genome
2 key takeaways:
- Mutational load is highly dependent on the cancer, of which melanoma is on the high end of the spectrum, 75k mutations per Mb of human genome
- Cancers cells are inherently genetically unstable, can generate a lot of variants to evade immune response
Altered glycolipids/glycoproteins
- Gl____ - glycolypid/glycoprotein m____ covering animal cells
- Tumours really manipulate this surface
- Highly robust on cancer cells
- Promotes i___ c____, g___ f___ s____, m_______
- Enhances cancer cell g___ and s___, m___ and m____
- A_____ forms/o___-e___ of cell-surface glycolipids/glycoproteins
- M___ e.g. MUC-1 (breast), CA-125 (ovarian)
- G____ e.g. GM2, GD3 (melanoma)
- Mutated
Altered glycolipids/glycoproteins
- Glycocalyx - glycolypid/glycoprotein matrix covering animal cells
- Tumours really manipulate this surface
- Highly robust on cancer cells
- Promotes integrin clustering, growth factor signalling, mechanotransduction
- Enhances cancer cell growth and survival, motility and metastasis
- Abnormal forms/over-expression of cell-surface glycolipids/glycoproteins
- Mucins e.g. MUC-1 (breast), CA-125 (ovarian)
- Gangliosides e.g. GM2, GD3 (melanoma)
- Mutated
- Abberantly expressed antigens
- Cancers can r_-e____ genes s___ in most adult tissues
- D____ eg. oncofoetal antigens: e.g. a___-f____
- a__-f____ re-expressed in h__c___ c___ (HCC)
- T___-s___ e.g. cancer-testis (CT) antigens: MAGE, NY-ESO-1
- MAGE-1 found in 37% melanomas
- NY-ESO-1 found in 46% melanomas
- O___-e_____ e.g. Her2-Neu e____ g___ f___ r___ gene a____ in breast cancer
- Unmutated tumour antigens
- Abberantly expressed antigens
- Cancers can re-express genes silent in most adult tissues
- Developmental eg. oncofoetal antigens: e.g. alpha-fetoprotein
- a-fetoprotein re-expressed in hepatocellular carcinoma (HCC)
- Tissue-specific e.g. cancer-testis (CT) antigens: MAGE, NY-ESO-1
- MAGE-1 found in 37% melanomas
- NY-ESO-1 found in 46% melanomas
- Over-expressed e.g. Her2-Neu epidermal growth factor receptor gene amplified in breast cancer
- Unmutated tumour antigens
- Cell-type speicifc differentiation antigens
- Tumours normally express antigens for c___ of o____
- Specific for cell l___/d____ stages (unmutated)
- Important targets for immunotherapy and diagnosis
- E.g. CD20 expressed by mature B cells and B cell lymphomas
- CD30 expressed on activated B cells and B cell cancers
- R____ (anti-CD20 antibody) is widely used in B cell leukaemia /lymphoma therapy
- T___ MRT1, gp75 and gp100 - common melanoma antigens (melanocyte lineage)
- Cell-type speicifc differentiation antigens
- Tumours normally express antigens for cells of origin
- Specific for cell lineages/differentiation stages (unmutated)
- Important targets for immunotherapy and diagnosis
- E.g. CD20 expressed by mature B cells and B cell lymphomas
- CD30 expressed on activated B cells and B cell cancers
- Rituximab (anti-CD20 antibody) is widely used in B cell leukaemia /lymphoma therapy
- Tyrosinase, MRT1, gp75 and gp100 - common melanoma antigens (melanocyte lineage)
Immune recognition of Cancer
- How mutated/foreign antigens are presented to the immune system
- Normal cell
- normal self peptides displayed on MHC, no ______ due to ____
- Tumour cell
- M___-g____ n_____ = new TCR contact residue, T cell response
- Tumour cell with oncogenic virus
- Peptide from a p____ encoded by an o___ v____
- T cell response
Immune recognition of Cancer
- How mutated/foreign antigens are presented to the immune system
- Normal cell
- normal self peptides displayed on MHC, no responding T cells due to tolerance
- Tumour cell
- Mutation-generated neoepitope = new TCR contact residue, T cell response
- Tumour cell with oncogenic virus
- Peptide from a protein encoded by an oncogenic virus
- T cell response
Immune recognition of Cancer
- How unmutated antigens are presented to the immune system
- De-r______ expression (e.g. cancer/t____ antigens)
- normally m____ gene gets de-m___
- t__ s___ p___ e___
- tumour antigen peptide with tumour specific CD8+ T cell
- O_____ of o__ p___ due to gene a____ (HER2-Neu in breast carcinoma)
- Large amount of protein = overcome low affinity of binding
- I___ number of cells e___ t___s___ p__ (e.g. t___ in melanomas)
- same as overexpressing
Immune recognition of Cancer
- How unmutated antigens are presented to the immune system
- De-repressed expression (e.g. cancer/testes antigens)
- normally methylated gene gets de-methylated
- tumour specific protein expression
- tumour antigen peptide with tumour specific CD8+ T cell
- Overexpression of oncogenic protein due to gene amplification (HER2-Neu in breast carcinoma)
- Large amount of protein = overcome low affinity of binding
- Increased number of cells expressing tissue specific protein (e.g. tyrosinase in melanomas)
- same as overexpressing
Recap
- The immune system responds to tumour cells but…
Which immune cell subsets elicit anti-tumour immunity and how?
Adaptive immunity vs innate immunity
Adaptive immunity to tumours
- CD8+ cytotoxic T lymphocytes (CTL)
- CD4+ T helper cells
Innate immunity to tumours
- NK cells