EXAM 4 Cancer Immunology

Question 1

the immune system has a role in suppressing ___

Answer 1

tumor growth

this is why immunocompromised patients will have more tumor growth than immunocompetent patients

Question 2

what immune cells are involved in the innate response of resisting a tumor?

Answer 2

NK cells, M1 macrophages, and M2 macrophages

Question 3

___ cells specialize in killing of cells with down-regulate MHC I, or that express NK receptor ligands

Answer 3

NK cells

Question 4

activation with ___ or ___ can convert NK cells to lymphokin activated killer cells that have potent anti-tumor activity

Answer 4

IL-2 or IFN-gamma

Question 5

___ macrophages secrete IFN-gamma and TNF-alpha that leads to an anti-tumor inflammatory environment

Answer 5

M1

Question 6

___ macrophages or myeloid derived suppressor cells can actually promote tumor growth by inhibiting appropriate immune responses

Answer 6

M2

Question 7

what cells are involved int he adaptive response in the induction fo anti-tumor response?

Answer 7

CD8 and CD4 T cells, and antigen presenting cells

Question 8

the induction of CD8 responses in anti-tumor response requires ___

Answer 8

cross-priming

Question 9

___ is released by CD8 T cells and causes lysis of the target

Answer 9

perforin

Question 10

___ is released by CD8 T cells and causes apoptosis and osmotic lysis of the cell

Answer 10

granzymes

Question 11

___ on the CD8 T cell and interact with ___ on the target cell, causing apoptosis of the target cell

Answer 11

• FasL
• Fas

Question 12

high dose ___ therapy causes the induction of complete regresion of metastatic melanoma, but only works 5-10% of the time

Answer 12

IL-2

Question 13

what are 6 types of tumor vaccines?

Answer 13

• killed tumor vaccine
• purified tumor antigens
• dendritic cell-based vaccines
• cytokine- and costimulator-enhanced vaccines
• DNA vaccines
• viral vectors

Question 14

most cancer vaccines to date have been ___ rather than ___

Answer 14

therapeutic, prophylactic

Question 15

what is adoptive cellular therapy?

Answer 15

• tumor bearing patient
• isolate lymphocytes from blood or tumor infiltrate
• expand lymphocutes by culture in IL-2
• transfer lymphocytes into patient, with or without systemic IL-2
• results in tumor regression

Question 16

antibody therapy

___ and ___ inhibit T cell responses. blocking antibodies against these have been developed. recent clinical data indicate that delivery of antibodies against these has a high rate of ___.

Answer 16

• CTLA4
• PD1
• melanoma patient response

Question 17

antibody therapy

___ can be blocked to eliminate transformed B cells

Answer 17

CD20

Question 18

what are the 3 E’s (phases) of cancer immunoediting

Answer 18

• elimination - immune system is winning
• equilibrium - immune system is killing off as many tumor cells as are arising (0 sum gain)
• escape - tumor cells are winning

Question 19

what cells are involved in the first phase of elimination, and what is produced?

Answer 19

• NKT cells, NK cells, gamma-delta T cells, macrophages, and dendritic cells
• IFN gamma is produced

Question 20

what happens in the second phase of elimination

Answer 20

• IFN gamma causes some tumor cell death
• stimulates chemokine production from tumor cells
• some chemokines inhibit angiogenesis and may cause additional tumor killing
• tumor cell debris take up by dendritic cells and taken to lymph nodes

Question 21

what happens during the third phase of elimination?

Answer 21

• NK cells and macrophages activate each other
• more tumor cells are killed
• induction of CD4 and CD8 T cells

Question 22

what happens in the fourth phase of elimination?

Answer 22

• tumor specific CD4 and CD8 T cells attempt to destroy remaining antigen-bearing tumor cells

Question 23

what happens during the equilibrium phase?

Answer 23

• any tumor variant that has survived elimination enters a dynamic equilibrium
• new variants arise that have increased resistance to immune attack
• equilibrium process may occur over a period of years

Question 24

what happens during the escape phase?

Answer 24

• surviving tumor variants that have acquired insensitivity to immune detection/elimination begin to expand
• clinically observable malignant disease occurs
• may lead to death of host

Question 25

angiostatic, direct cytotoxicity, and immune surveillance result in tumor ___, and involved what cells?

Answer 25

• regression
• NK/NKT, Th1, Th17

Question 26

pro-angiogenic, tissue remodeling, and immune suppression lead to tumor ___, and involve which cells?

Answer 26

• progression
• Th17, B cell, Th2, Treg

Question 27

myeloid derived suppressor cells activate what?

Answer 27

• Treg cells
• type II response
• macrophages

Question 28

myeloid derived suppressor cells inhibit what?

Answer 28

• DCs
• CD8 and CD4 T cells
• NK cells