General Cancer Overview

Question 1

What are common tumor suppressors?

Answer 1

P53 (gateway to the genome), P16, RB1, BRCA

Question 2

What are common Oncogenes?

Answer 2

Ras/PI3K, cyclins, tyrosine kinases (TKRs)

Question 3

What are CDK4/6 inhibitors?

Answer 3

prevents phosphorylation of RB1 (tumor suppressor gene) arrests cell cycle in G1 phase

Question 4

What medications are CDK4/6 inhibitors?

Answer 4

ribociclib, palbociclib, abemaciclib

Question 4

What is the most common reason for resistance to multiple chemotherapies at once?

Answer 4

drug transport out of cells

Question 5

What does the resistance method of altered drug metabolism consist of?

Answer 5

1. increased transport of drugs out of cell via efflux pumps
2. decreased transport of drug into cell
3. decreased activation of prodrug
4. increased detoxification of drug molecule (via increased metabolism)

Question 6

What does the resistance method of changes in drug target or function consist of?

Answer 6

1. increased expression of drug target through gene amplification or expression
2. emergence of a mutant, structurally altered target
3. emergence of cells with rewired pathways that bypass the need for the target drug

Question 7

What does the resistance method of physiological changes that promote resistance consist of?

Answer 7

1. cancer cells hide in areas the drug cannot access (i.e. within the blood-brain barrier)
2. Massive stromalization (cells become fibrous, tough in nature preventing drug access)
3. cell state changes (slowing of cell cycle, increase in drug efflux pumps, increase in anti-apoptotic proteins)

Question 8

What does the resistance method of cell survival mechanisms consist of?

Answer 8

1. increase in anti-apoptotic regulators
2. increased repair of damage caused by chemotherapy

Question 9

Which of the following terms is associated with substitution of one tissue type for another?

Answer 9

Metaplasia