Oncology 2 petronini Flashcards

1
Q
  • 1910: discovery of the first oncogenic virus called?
A

“Rous sarcoma virus
it is able to induce sarcoma when inoculated in a chicken leg

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2
Q
  • 1960: identification of a gene present in the genome of the Rous sarcoma virus responsible for
A

the sarcoma induction
This oncogene is called v-Src (Src is the abbreviation of “sarcoma”)

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3
Q
  • 1974: demonstration that in the genome of normal cells (even in that of cells that have never
    been in contact with the virus) there’s a gene called Src which is a ______________, the normal
    version of an oncogene.
A

proto-oncogene
These genes are really useful during embryogenesis and differentiation due to their cell proliferation control abilities, which is why they show high evolutionary conservation and are expressed by
normal cells.
We have called the product of these genes “accelerators” since they stimulate proliferation in cells.

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4
Q

what are slow transforming retroviruses or chronic retroviruses?

A

These viruses don’t transform the cells in culture and are able to induce tumors but in a
very long time span. In fact these viruses to induce the tumor need to integrate their genome near
a proto-oncogene.
Why when the genoma of retroviruses is inserted into host DNA near a proto-oncogene induces a
tumor? Because these viruses have two sequences called “long terminal repeats”, that contain
promoter and enhancer sequences which are really strong, so they can modulate the expression of
the proto-oncogene. In this situation the proto-oncogene is expressed at very high level.

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5
Q

A proto-oncogene can become an oncogene by two modalities:

A
  1. Qualitative: the oncogene is mutated, the sequence is mutated from the normal one (the proto-oncogene);
  2. Quantitative: the product is expressed at really high levels.
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5
Q

Right now we know a lot of viral oncogenes. Here are some examples:

A

-The v-onc present in the “ Rous sarcoma virus” was called: v-src
-The v-onc present in the “feline sarcoma virus” was called: v-fes
-The v-onc present in the “simian sarcoma virus” was called: v-sis

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6
Q

The difference between an acute virus and a chronic one is the presence of __________ in the acute one,
absent in the chronic one.

A

v-onc

Both contain:
-Gene gag: encoding for internal structural proteins
-Gene pol: encoding for reverse transcriptase, integrase and protease
-Gene env: coding for outer viral envelope proteins. In the case of HIV in that region of the virus we
have gp120 and gp41 (glycoproteins).
-LTR: regulatory sequences (contain transcriptional promoters and enhancers)
Src is the oncogene src.
These enzymes are very important for the replication of the virus.

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6
Q

Steps of the retroviral replication cycle:

A
  1. binding to the cell membrane receptor (CD4 is the receptor for Hiv and binds with very high affinity gp120);
  2. release of genetic material into the cytoplasm (the genome of a retrovirus is composed by two
    molecules of single filaments of RNA);
  3. the RNA filament is retro-transcribed into DNA filament, so you obtain a DNA double strand
    called provirus, then integrated in the cell genome;
  4. when the DNA of the cell is transcribed also the viral one is transcribed, this RNA will be the
    virus genetic material, the mRNA will codify for viral proteins and will translate into viral proteins.
    At the end we have the budding of the virus, when a piece of cell membrane is taken up by the
    virus and, together with envelope proteins, constitute its new envelope.
    In this case the information is not from DNA to protein, but from RNA to DNA to RNA protein.
    Temin and Baltimore described this replication process.
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7
Q

________are not present in all oncogenic viruses, for example in chronic retroviruses they are absent.
To induce the formation of a tumor the viral genome has to be integrated near a proto-oncogene.
[Src for example]

A

V-onc

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7
Q

Typical characteristics of transformed cells:

A

A transformed cell has specific characteristics:
* Changes in cell morphology
* Changes in growth (no contact inhibition)
* Growth capacity independent of growth factors, they are also able to grow in medium without
serum (fetal calf serum able to induce the proliferation of fibroblast or epithelial cells). In serum
are present pdgf, egf, insulin growth factors, fibroblast growth factors. Most of these growth factors are released into the serum during platelets clotting.
* Unlimited growth capacity (immortalization), autocrine stimulation growth. (One of the 3 ways of
Communication between cells, the others are paracrine and endocrine)
* Alterations in the differentiation
* Anchor-independent growth capacity, transformed cells are able also to grow in soft agar, normal
cells don’t because in this situation interaction to the extracellular cell matrix is lacking. A proliferation of a normal cell depends on two signals: soluble factors (pdgf) and extracellular matrix.
* Transformed cells don’t need serum, they can grow even without it

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7
Q

In the course of evolution RNA viruses acquired the cellular oncogene from animal genomes by
_________________

A

genetic recombination

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8
Q

characteristics of Acute transforming retroviruses?

A
  • Contain oncogenes (v-onc)
  • Are defective in the replication
  • Induce polyclonal tumors (100% efficiency) in a few days
    The v-onc originates from a proto-oncogene that is embedded in the genome of a retrovirus that
    has replicative capability.
    The v-onc differs from the proto-oncogene by:
  • Lack of introns
  • Truncated gene (e.g. v-Src)
  • Presence of point mutations (ex. v-ras)
  • Frequent fusion between viral and oncogene gene (e.g. gagonc or env-onc)
  • Very high expression under LTR control
    Here some examples // no need to remember all of these, just v-src //
    V-src is a cytoplasmic tyrosine kinase
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9
Q

characteristics of Chronic transforming retroviruses?

A

They do not have v-onc. Remember this example : Avian leukosis virus (ALV), that induces
leukemia in birds.
The provirus is ALWAYS integrated in the same position of the cellular genome, this is important
because only in this condition you have the appearance of the tumor that is monoclonal. In ALV-induced tumors, provirus is always integrated near the v-myc gene, expressed at very high level.
The effect can be related to the promoter but also to the enhancer activity of specific viral sequences.

During the insertion there’s the possibility of insertional mutagenesis, retroviruses are able to transform the cells because they have the viral oncogene or they integrate the genome near a protooncogene that is over expressed or mutated by insertional mutagenesis.
Crucial event for transformation is therefore rare and cells forming a tumor are a clone (monoclonal
tumors).
Retrovirus insertion near the proto-oncogene v-myc increases cell protein expression and makes it
independent of normal control systems.
Even if they do not have a v-onc the end result is the same as if the virus encodes a v-onc.
Leukemia lymphoma is one of the few tumors we can get from these viruses, since they are not
that harmful for humans, but they are really important because thanks to them we discovered
oncogenes.

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10
Q

normal proto-oncogenes can, independently from viruses, undergo such
modifications that they become real cellular oncogenes which, in this case, take the name of _________

A

c-onc.
A proto-oncogene is therefore a normal gene, essential for cell growth, that can however become
oncogene due to mutations or increased expression.

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11
Q

Why a proto-oncogene becomes mutated?

A

There are physical, chemical (UV radiations, ionizing radiations…) and biological causes.
The gene changes (mutations) that transform proto-oncogenes into oncogenes are mainly of two
functional types:
- Changes in the structure of the gene (point mutations) resulting in the synthesis of a qualitatively
abnormal gene product with ‘aberrant and/or resistant to down-regulation mechanisms of
activity’.
- Changes in the regulation of gene expression that cause an increased synthesis of normal protein but no longer quantitatively adjustable.
The main types of mutations responsible for both conditions are: point mutations, chromosomal
rearrangements (inversions, translocations), deletions, gene amplification.

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11
Q

___________ derive from proto-oncogenes for qualitative or quantitative alterations. Proteins encoded by ___________ are compared to accelerators that make cell division faster and more autonomous.

A

Oncogenes, oncogenes

12
Q

MECHANISMS OF ACTIVATION OF ONCOGENES:

A
  1. Deletion or point mutation in the coding sequence (hyperactive protein)
  2. Gene amplification (Normal proteins produces in large excess)
  3. Chromosomal rearrangement (fusion with a very transcribed gene: hyperproduction or hyperactivity of the fusion protein)

An example is ras proto-oncogene becomes oncogene by point mutation (in smokers this mutation
is present).
We can also have an increase in the synthesis of an encoded protein when there’s an amplification
of gene or a DNA regulatory sequence translocation. In humans myc is present on chromosome 8,
in Burkitt’s lymphoma is translocated to chromosome 14, 2, 22. In this areas we have the promoter
that controls the antibody, composed by two heavy and two light chains. This cause a different
regulation of myc, we call it deregulation.
We also have the synthesis of a protein containing portions encoded by different genes, the fusion
protein generated is no longer under normal control, fusion protein, fusion messenger and fusion
genes are created. For example the translocation 9.22 present in chronic myeloid leukemia or in
acute lymphoblastic leukemia. The gene translocated is called ABL, it codifies for cytoplasmic tyrosine kinase, in this case it is translocated near BCR resulting in a gene fusion BCR - ABL. The fusion protein is more active than ABL.

13
Q

CETUXIMAB?

A

monoclonal antibody that binds EGFR

14
Q

EGFR GEFITINIB-ERLOTINIB-OSIMERTINIB?

A

tyrosine kinase inhibitors of EGFR (osimertinib is
the third generation, aka the best/newest)

15
Q

TRASTUZUMAB?

A

anti HER-2 antibody

15
Q

Breast cancer is classified by three molecules :

A

Estrogen receptor, progesterone receptor, and the
amplification of HER2. When a tumor expresses ER or PGR the patient is treated with endocrine
therapy. Patients that overexpress HER2 are treated with a monoclonal antibody called
trastuzumab.

15
Q

Translocation 9-22 with the formation of the ____________________ ( = chromosome 22 smaller after translocation). There’s the formation of a chimeric BCR/ABL fusion gene that produces a protein similar to that produced by ABL but constitutively active.

A

Philadelphia chromosome

16
Q

what is FISH (FLUORESCENT HYBRIDIZATION IN SITU)?

A

It’s a method that allows us to identify the translocation 9;22 characteristics of the CML.

16
Q

The ___________ hybrid protein was the first target for biological therapy: imatinib (the first targeted drug) is
a selective inhibitor of the hybrid protein

A

Bcr-Abl

16
Q

Twenty years ago people were treated with chemotherapy and didn’t survive chronic myeloid
leukemia. Now people survive. 95% of them survive thanks to _____________. This does not cure the patient who has to assume imatinib during all life because some stem cells with this alteration are always present. If you block the oncogenic driver you can save the patient causing a regression of
the tumor.

A

imatinib

17
Q

When B-RAF is mutated in
melanoma, there is a drug that inhibits B-RAF mutated: _____________. Ten years ago melanoma
was treated only by chemotherapy

A

vemurafenib

17
Q

Gene amplification of the myc gene in ___________________.
There are two different aspects of myc amplification: homogeneously stained region (HSR) and
extrachromosomal particles called double minutes.

A

human neuroblastoma

18
Q

Chromosomal translocation 8-14 of the myc gene in _______________.

A

Burkitt’s lymphoma
The myc gene from chromosome 8 is translocated to chromosome 14 near the gene locus for heavy immunoglobulin chains,
leading to hyperexpression of myc.

19
Q

c-myc’s role in the proliferative event:

A
  • Activation of genes for cyclins D, E, A
  • Activation of genes for Cdk2- Cdk4
  • Activation of the ODC gene (ornithine decarboxylase involved in polyamine biosynthesis)
  • Repression of genes for CdkI
  • Metabolic Reprogramming (Warburg Effect)
  • Overexpression of telomerase
  • Contributes to stability
    At this time there are no drugs able to cure Myc mutations.
19
Q

_______ is an intracellular sensor and transducer of extracellular stimuli. It responds to growth factors,
cytokines, and cell adhesion molecules; it’s inhibited by contact inhibition by TGF beta and by differentiation. The oncogenic mutation affects a lot

A

Myc

20
Q

Cell cycle inhibitors are CIP/KIP family :

A

p21, p27, p16

21
Q

CHROMOSOMAL INVERSIONS:

A

Inversion of chromosome 16: acute myeloid leukemia (favorable prognostic factor)
Inversion chromosome 3: acute myeloid leukemia (unfavorable prognostic factor)
Prognostic factor = probability of surviving excluding the therapy

22
Q

Karyotype abnormalities in tumors:

A

Certain chromosomal abnormalities are linked to particular neoplasms and play a pathogenetic
role but also are predictive of response to therapy.
This is especially relevant in cancers such as leukemia and lymphomas.

23
Q

KARYOTYPE CHANGES IN TUMOURS:

A

Cancer cells often have deviations from the normal diploid value (n=46) of the chromosomes.
These cytogenetic changes affect the ploidy (number) or morphology (structure) of chromosomes
and/or combinations of both alterations.
NUMERICAL:
Hyperdiploid karyotypes
Numerical instability (aneuploidy)
STRUCTURAL:
Amplifications
Deletions
Translocations
Inversions
Structural alterations are connected to the pathogenesis of the tumor, while numerical ones are
relevant in tumor progression.

24
Q

Aneuploidy is associated with:

A
  • Poor prognosis and increased aggressiveness
  • Phenotypic variability and increased tumor heterogeneity
  • Promotion of metastases
  • Resistance to antineoplastics
  • Aneuploidy promotes tumor progression
25
Q

Translocations to remember:

A
  • Translocation 8;14 (8;2 or 8;22): Burkitt’s lymphoma
  • Translocation 9;22: Chronic myeloid leukemia
  • Translocation 15;17: Acute promyelocytic leukemia
25
Q

Molecular pathogenesis of acute promyelocytic leukemia:

A
  • The maturation of normal granulocyte precursor is obtained by retinoic acid
  • In acute promyelocytic leukemia with translocation 15;17 chromosomes, you obtain the PML-RARA
    fusion gene; in this case, retinoic acid isn’t able to induce terminal differentiation, so you have
    a block in maturation. You remove the block by ATRA.
26
Q

Amplifications to remember:

A

HER2: breast cancer
N-myc: neuroblastoma