Genetics Of Cancer Flashcards

0
Q

What are the features of genetic predisposition?

A

Family history
Early onset cancer
Multiple cancers - bilateral organs
Other abnormalities - DNA repair deficiency

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1
Q

What percentage of cancers are sporadic?

A

95% from somatic mutations

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2
Q

How are predisposing genes cloned?

A

Conventional positional cloning - linkage analysis

  • chromosomal abnormalities
  • allele loss studies
  • whole genome sequencing
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3
Q

What types of predisposing genes have indirect involvement in cancer?

A

DNA repair genes

Those involved in carcinogen metabolism

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4
Q

What type of predisposing genes have a direct involvement in cancer?

A

Tumour suppressor genes

Proto-oncogenes

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5
Q

What are the features of ataxia telangiectasia?

A

Rare autosomal recessive
Ataxia
Telangiectasia- dilated capillaries at body surfaces
Immune deficiency
Sensitivity to ionising radiation
Predisposition to leukaemia and lymphoma
Heterozygotes have increased cancer risk - don’t manifest AT symptoms

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6
Q

What is the gene affected in AT?

A

ATM
Senses changes in chromatin structure when DNA damaged
Phosphorylates p53 after damage
AT cells cannot arrest cell cycle in response to DNA damage

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7
Q

What are the features of Xeroderma pigmentosa?

A
Rare, autosomal recessive 
Dwarfism
Mental retardation
Blindness and deafness
Severe UV sensitivity - develop cancer of every sun exposed part of body
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8
Q

What genes are affected in XP?

A

Involved in DNA excision repair
Mutations in any of 7 genes
Two thymines combine to form a big lesion

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9
Q

What are the features of Bloom syndrome?

A

Rare autosomal recessive
Leukaemia and lymphoma
DNA helicase deficiency
Chronic lung disease and diabetes

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10
Q

What are the features of Fanconi anaemia?

A
Rare autosomal recessive
Anaemia
Mental retardation
Skeletal abnormalities
Leukaemia
12 genes involved in regulation of DNA repair by homologous recombination
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11
Q

What is homologous recombination?

A

Repairs DNA damage
Uses opposite strand as template to check for damage
When it goes wrong - cancer

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12
Q

What is BRCA likely to cause if mutated?

A

Inherited breast cancer
One mutant copy needed
Susceptibility to childhood cancer depending on how mutation is inherited
Can also cause Fanconi anaemia due to a mutation

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13
Q

What is mismatch repair?

A

A DNA repair system whereby one member of a mismatched pair of bases is converted to the normally matched base.

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14
Q

What are the features of hereditary non-polyposis colon cancer?

A

Autosomal dominant
Early onset colon cancer
Few adenomas
Mutations in mismatch repair genes

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15
Q

What is carcinogen metabolism?

A

Body metabolises compounds to get rid of them - some carcinogens activated by this
Cytochrome P450-dependent enzymes involved
Can measure activity of CYP2C9 by ability to hydroxyl ate debrisoquine
Rapid metabolisers may have increased cancer risk

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16
Q

What is retinoblastoma?

A
Childhood eye tumour
1:20000 incidence 
Autosomal dominant but gene is recessive
Hereditary
Knudsons 2 hit theory
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17
Q

What is knudson’s two hit theory?

A

Hereditary tumours - first hit germ line (carry mutation in every cell in body), second hit somatic
Sporadic tumours - first hit somatic, second hit somatic

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18
Q

What is the supporting evidence for Knudson’s two hit theory?

A

First hit usually small point mutation or deletion - second hit is large scale with loss of an allele (loss of heterozygosity) usually by nondisjunction and duplication
Somatic cell hybrids with normal and cancer cell -> nontumorigenic heterokaryon -> loss of specific chromosomes that suppress cancer cells -> tumorigenic revertant

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19
Q

Oncogenes vs TSGs

A

Oncogenes - gain of function

  • dominant mutations (point, amplification, chr translocations)
  • mutations rarely inherited

TSGs - loss of function

  • recessive mutations (point, deletions, epigenetic silencing)
  • many inherited mutations
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20
Q

What is RB1?

A
Retinoblastoma TSG
Mutated in all retinoblastomas and some other cancers
Large gene
Encodes nuclear phosphoprotein
Involved in regulating cell cycle
21
Q

How can viruses cause retinoblastoma?

A

E1A (adenovirus), E7 (papilloma virus) and SV40 tag bind to unphosphorylated version of RB1 keeping it in cell cycle

No need for transcription factors

22
Q

What are the features of Wilm’s tumour?

A

Childhood kidney tumour
WAGR (Wilm’s tumour, aniridia, genitourinary abnormalities, mental retardation)
11p13 deletion
WT1 gene - TSG encodes DNA/RNA binding zinc finger proteins which have role in regulating transcription
Follow 2 hit theory

23
Q

What is p53?

A

Discovered as protein that bound to SV40 T antigen
17p deletion and mutations found in human cancers
Regulates transcription
Increases with DNA damage to arrest G1
High levels in tumours
Functions as tetramer

24
How does p53 work with mdm2?
Mdm2 degrades p53 Normal cells p53 is low Mutant p53 - decrease mdm2 so p53 degradation decreases
25
What is the function of RET?
Encodes receptor tyrosine kinase Binds GDNF Mutations cause it to be constitutively active
26
What diseases are caused my germline missense mutations in RET?
MEN2A (multiple endocrine necrosis 2A) MEN2B FMTC (familial medullary thyroid carcinoma) Autosomal dominant syndromes that map to same region of chr10q
27
What are the symptoms of MEN2A?
Thyroid cancer Parathyroid cancer Pheochromocytoma - benign tumour of adrenal medulla which increases Bp by releasing high spikes of adrenaline.
28
What are the symptoms of MEN2B?
Like 2A but no parathyroid hyperplasia | Ganglioneuromas
29
What are the symptoms of FMTC?
Thyroid cancer
30
What is MET?
Encodes receptor tyrosine kinase Binds hepatocyte growth factor Chr7q
31
What disease is caused by germline missense mutations in MET?
Hereditary papillary renal carcinoma Mutations homologous to RET mutations Somatic mutations in kidney cancer
32
What is KIT?
Encodes tyrosine kinase receptor for stem cell factor Important in development Somatic and germline mutations in gastrointestinal stromal tumours
33
What is ALK?
Encodes tyrosine kinase receptor Unknown ligand Somatic and germline mutations in neuroblastoma - childhood cancer
34
What is CDK4?
``` Proto-oncogene Phosphorylates RB1 Involved in S phase entry p16 (TSG) inhibits Mutations cause familial melanoma ```
35
Why is the RAS pathway important?
Activates cell signalling pathways | If mutated causes cancer(k-ras), facial and heart defects, developmental abnormalities
36
What indications are needed to screen for an inherited predisposition to cancer?
Family history Early onset tumours / multiple tumours Abnormalities
37
What tests are used to screen for cancer?
Karyotype- rare to get cytogenetic abnormalities Sequence gene - known mutation Normally point mutations that can't be seen by microscope
38
What are the benefits of screening for cancer?
Early screening Genetic counselling Prenatal diagnosis
39
How is gene expression used to diagnose tumours?
Expression profiling using microarrays - screen whole genome for gene expression to see patterns of tumours Expression profiling using 2nd generation sequencing - shoes small RNA sequences, looks at all transcripts
40
How are chromosome translocations used to diagnose tumours?
Many cancers have specific translocations Used fusion protein to fuse together path of two genes to make a novel protein - chronic myelogenous leukaemia 9:22 translocation
41
How are immunoglobulin and T cell receptor rearrangements used to diagnose tumours?
Monoclonal rearrangements indicate leukaemia or lymphoma | Leukaemia is a clone of B/T cells - pick up using FISH
42
How is whole genome sequencing used to diagnose tumours?
2nd generation sequencing to detect all mutations and chromosome rearrangements Widely used Shows which genes are most highly mutated in certain cancers
43
Why is knowing the prognosis of cancer important?
How tough does treatment have to be? Gene amplification - multiple copies shows as homologous staining regions....used as way of deciding treatment Residual disease - immunoglobulin and T cell receptor clonal rearrangements can detect residual leukaemia cells in bone marrow - lower detection limit to determine if disease has actually gone. Expression profiling using microarrays and RNA-seq
44
Why are microarrays used?
Shows which genes are more highly expressed
45
How is a microarray done?
Make cDNA Label Hybridise to microarray
46
How is a RNA-seq done?
Library of cDNA short sequence repeats Align Allows tumours to be divided into subgroups for prognosis deepening
47
What is used to look for gene amplification?
Southern blotting
48
How is gene therapy used to treat cancer?
TSG replacement Antisense RNA to oncogenes RNA interference - gene missing that interacts with p53 Possible but not used
49
How can our knowledge of p53 be used to treat cancer?
Use anti-p53 virus that selectively kills cells with mutant p53
50
How can drugs be used to treat cancer?
Gleevec inhibits bcr-Abl kinase in CML Gefitnib inhibits EGFR in lung cancer Only work if patient has corresponding molecular defect