Introduction

Question 1

Tumorigenesis

Answer 1

Microevolutionary process: mutation > competition > natural selection
Goes on even when the tumour has established in terms of aggressiveness
Evolution speed and parameters on which it depends
Mutations: how many pathways have to be altered, on which genes
Genetic instability
Resistance to apoptosis
Metastatic process and neoangiogenesis as selection moments

Question 2

Mutagenic factors

Answer 2

Difference between initiators and promoters
Environmental factors
Lifestyle
Age
Hormones (ex. breast cancer and age at the first pregnancy)

Question 3

Warburg effect

Answer 3

Aerobic glycolysis and subtraction of glucose (PET)
Reverse Warburg effect

Question 4

Anti-cancer therapies

Answer 4

Conventional: surgical removal, chemotherapy and radiotherapy > they exploit the genetic instability
Genetic instability and development of resistance (mention of CSCs)
Mechanisms of resistance: MDRs, over expression of targets
Examples: Tamoxifen, TKIs and immunotherapy