Oncogene & Tumor Suppressor Control Pathways in Oral Squamous Cell Cancer I & II Flashcards
How many new cases of oral cavity/oropharyngeal cancer occur in the US?
About 58,450 new cases (1 in 6000)
How many deaths occur in the US from oral cavity or oropharyngeal cancer?
About 12,230 deaths
Oral cavity & oropharyngeal cancers occur most often in which sites?
The tongue
The tonsils & oropharynx (parts of the throat behind the mouth)
The gums, floor of the mouth, & other parts of the mouth
Almost all cancers in oral cavity & oropharynx are…
squamous cell carcinomas or squamous cell cancers
Infections with certain high-risk types of ___ cause most of the squamous cells cancers of the oropharynx
HPV
HPV is rarely associated with what?
oral cavity cancer
HPV + cancers are seen more often in who?
young people with no history of tobacco or alcohol use
HPV + cancers tend to have what kind of prognosis than squamous cell cancers not related to an HPV infection?
better prognosis
What are the 2 main classes of genes involved in tumorigenesis?
oncogenes & tumor suppressor genes
Describe oncogenes
Encode proteins that actively promote aberrant cellular proliferation
Activity is up-regulated in tumor cells (K-Ras mutations in pancreatic cancer), gene amplification (MDM2 in soft tissue sarcomas), chromosomal translocations (BCR-ABL in CML). Present within genomes of tumor promoting viruses
Describe tumor suppressor genes
Encode proteins that negatively regulate cell proliferation
Activity down-regulated in tumor cells (loss of function mutations, gene deletion, promoter methylation)
Malignancy is a ___ ____ process
multi-step
Cancer is a ___ ___ process involving both the activation of ______ and the inactivation of ____ _____ ____
multi-step; oncogenes; tumor suppressor genes
What have given us important info on the nature of mutations in human cancers?
Large scale exome sequencing projects sequences DNA from thousands of different tumors
Oncogenes are recurrently mutated at which AA position?
The same AA position
Tumor suppressor genes are mutated through what? 9
Protein-truncations alterations (nonsence, missense mutations throughout their length)
3 molecular processes relevant to cancer
Cell fate
Cell survival
Genome maintenance
Cell fate 11*
Many of the genetic alterations in cancer abrogate the balance between differentiation & division, favoring the latter
Cell survival 12*
Even though cells divide abnormally bc of cell-autonomous alterations like those controlling their fate, their surrounding stromal cell don’t keep pace
This leads to abnormal vasculature of the growing mass & severe growth factor & nutrient limitations
So a cancer cells getting a mutation in growth factor receptor or downstream signaling molecule that lets it proliferate under limiting nutrient concentrations will have a selective growth advantage
Genome maintenance
Mutation in DNA repair factors can also act earlier in the transformation process by accelerating the acquisition of mutations that function through the process of cell fate/survival
13* The Epidermal Growth Factor Receptor tyrosine kinase is frequently found…
Over-expressed in epithelial tissues. Gene amplification common mechanism
What is the most common Ras mutation from COSMIC?
G12V is the most common
For RAS mutations from COSMIC, what is the type of classic recurring mutation at particular residues in the protein?
Classic recurring missense mutation
What are 5 of the top 20 mutated genes by tissue?
TP53 (45%)
CDKN2A (11%)
FAT1 (24%)
CASP8 (15%)
BRCA2 (6%)
What type of gene is FAT1?
Tumor suppressor gene
What overall type of mutation does FAT1 undergo?
Loss of function
What are two types of specific mutations scene in FAT1? 17
Nonsense substitution (40.57%)
Missense substitutions (19.81%)
What type of mutation is seen with the CDKN2A gene (p16)?
Nonsense substitution (56.82%)
Most cells in our bodies aren’t in cell cycle. In absense of mitogenic stimulation they exit the cell cycle into ____
G0 (quiescent state)
Which cells enter G0 reversibly
stem cells, hepatocytes, etc.
Which cells irreversibly enter G0? *in most cases leads to terminal differentiation
RBCs & epithelial cells
Eukaryotic cell cycle progression is triggered by what?
Cyclin Dependent Kinases (CDKs)`
What do CDKs do?
Phosphorylate other regulatory and structural proteins thereby controlling expression and activities of replication enzymes and cell cycle factors
What is CDKN2A gene (p16) induced by?
Signals that promote cell cycle exit
What do loss of function mutations promote?
Aberrant cell proliferation
CASP8 & apoptosis is a classic _______ example
loss of function
What are 2 mutations for CASP8?
Nonsense substitution (26.44%)
Missense substitution (55.17%)
In 1842, Karl Vogt…
noticed cells in notochord “disappeared” and were replaced by cells of vertebrae
1972: Kerr, Wylie, Currie
Apoptosis suggested an active, inherently programmed phenomenon
1973: 3 classes of cell death
I: Cell shrinkage, membrane blebbing, DNA fragmentation, chromatin condensation (apoptosis-regulated cell death)
II: Formation of large scale autophagic vacuolization containing cytosolic materials and organelles (autophagy-regulated cell death)
III: Loss of membrane integrity and swelling of subcellular organelles (accidental and regulated cell death-necrosis)
1990s, Robert Horvitz got 2002 Nobel prize for…
Identification of key apoptosis genes in C. Elegans
Apoptosis 6 points
Outer membrane blebbing
Shrinking
Condensation of the nucleus
Fragmentation of chromosomes
Formation of cytoplasmic vacuoles
Cell fragments generated by apoptosis are taken up and eliminated by neighbouring cells and phagocytes
Describe apoptotic signaling via extrinsic pathway in 5 points
25*
Mediated by death receptors (e.g. CD95, TNFR1, TRAIL)
Formation of DISC (death-inducing signaling complex)
Recruitment of pro-caspase 8 (cysteine dependent aspartic specific proteases) and self-cleavage
Activation of effector caspases 3,6, and 7. Destruction of essential cellular proteins
Can also feed into the intrinsic pathway by cleavage of the BH3 only protein BID
Describe apoptotic signaling via intrinsic pathway in 5 points
Marked by one central event: mitochondrial outer membrane permeabilization (MOMP)
Results in release of cytochrome C from mitochondrial intermembrane space
Cytochrome C triggers assembly of a caspase-activating complex between caspase 9 and APAF1 (apoptotic protease activating factor 1) via Caspase Recruiting Domain (CARAD) of APAF1
Also leads to release of AIF & Endonuclease G, which degrades DNA
Caspase 9 activates effector caspases 3, 6, and 7, which destroy essential cellular proteins
Main mutations involved in BRCA2 gene and genomic instability
Missense substitution (46.67%)
Frameshift insertion (36.67%)
Recombination is a mechanism with ___ distinct functions
2
Describe 2 functions of recombination
- In all cells, repair of double strand damage to chromosomes
- In germ line cells undergoing meiosis, shuffling genetic info between homologous chromosomes (allows redistribution of parental genetic traits)
Further explain repair of ds damage to chromosomes
When both strands are damaged, use the info from homologous chromosome to replace lost info
What enzymatic activities are required for homologous recombination? 30*
5’-3’ exonuclease
Recombinase
DNA polymerase
Ligase
Resolvase
BRCA2 loss promotes what?
DNA loss
Genomic instability
In response to DNA damage, what does p53 tumor suppressor do?
Halts cell cycle to allow DNA repair
p53 is…
The most frequently mutated gene in oral cancer
In a tumor cell lacking p53…
Cell division continuous with damaged chromosomes (genetic instability) and this can result in:
Massive mitotic failure and cell death where tumor regresses
or
Continued mutation, selection, and tumor evolution (cancer)
The p53 tumor suppressor is also a transcription factor that does what?
Up-regulated genes that negatively regulate proliferation in response to various stress signals