Lecture 6 Flashcards
What two mechanisms can cancers use to spread?
Invasion - Migration and penetration into neighbouring tissues
Metastasis - Penetration of lymphatic or blood vessels, circulation and colonization of normal tissue at a distant site
Outline the basic steps of the metastatic cascade
- Primary tumour formation by transformed cells
- Proliferation and angiogenesis
- Detachment and invasion in circulatory system
- Embolism/ciculation
- Extravasion
- Proliferation and angiogenesis at distant site to form a metastatic tumour
Why is metastasis a problem?
Large decrease in survival rate
90% of cancer deaths due to metastasis
Why are metastatic cancer cells a large area of study?
Due to decrease in survival rate
Also when in transport may be easier to target so possible treatment route
What are the three main theories for how metasis can occur?
- A minortity of tumour cells are able to metastasis (supported by stem cell theory)
- All tumour cells in population can metastasis (supported by gene expression profiling)
- Subpopulations within tumours have potential to metastasis to specific places
What type of cells exist in a heterogenous tumour environment?
- Cancer cells
- Immune-inflammatory cells
- Cancer associated fibroblasts
- Endothelial cells and pericytes (for blood vessels)
- Cancer stem cells
- Invasive cancer cells
What does heterogenous tomour population give rise to?
How was it first shown?
Heterotypic signalling
By Van Scott and Reinertson in 1962
Transplanted skin tumours to different sites on body. Only tumour cells transplanted with carcinoma-associated stromal cells were able to form new tumour at distant site
Give two examples of how cancer cells use positive feedback loops for their growth
- Release signals with stimualte mesenchymal stem cells to release CCL5 which will stimulate cancer cell invasion
- Release chemotactic factors to cause circulating monocytes to become tumour-associated macrophages, whcih release:
- EGF to promote cancell cell survival and proliferation
- Proteases to disrupt ECM ctreating more space and releasing angiogenic factors
- Angiogenic factors to cause angiogenesis
What is the implication of the cross-talk and feedback between cancer and non-cancer cells?
Tumours are not dependent on new mutations to allow them to metastasis, but can use cross-talk with other cells to lead to their ability to metastasis
What are the consequences of being too far from a blood vessel?
Hypoxic and anoxic areas
- Low pH
- Low O2
- Low ATP
- Low Glucose
- High lactic acid
Outline the basic process of angiogenesis
- Cells lacking O2 release angiogenic factors
- Recruited cells can then orchestrate an inflammatory response
- Release of TNF-α and prostoglandins will promote angiogenesis
- Endothelial cells then release PDGF and HB-EGF to attract pericytes and smooth muscle cells to build the blood vessel
What factor of sodium channels has been shown to be important for angiogenesis?
ß1 factor which has been to cause increased angiogenesis and increased levels of VEGF
What was thought to be a major advantage of anti-angiogenesis therapy?
Targeting normal cells which would be more susceptible to treatment
What drugs are in use to target angiogenesis?
Bevacizumab - which targets VEGF
Why is bevacizumab thought to not be as successful as hoped?
Although stops angiogenesis initially and hence stops tumour growth leads to hypoxia which may stimulate endothelial to mesenchymal transition and save angiogenesis. May also lead to intravasation, extravasiation, vessel co-option or thrombosis. All of which cause increased invasive ability of the tumour.