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Cancer Y2 > Role Of The Immune System In Cancer > Flashcards

Role Of The Immune System In Cancer Flashcards

1
Q

3 states of immune system-cancer interaction

A

Elimination
Equilibrium
Escape

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2
Q

Process of cancer elimination by the immune system

A

Release of cancer cell antigens -> antigen presentation -> priming and activating immune cells -> trafficking T cells to tumours -> infiltration of T cells into tumours -> recognition of cancer cells by T cells -> killing of cancer cells

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3
Q

Cancer-immune system equilibrium

A

Cancer cells present but held in place by immune system

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4
Q

3 main groups of immune system escaping tumours

A

Immuno excluded tumours
Immune desert tumours
Inflamed tumours

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5
Q

How do inflamed tumours escape the immune system

A

Immune cells present but don’t kill cancer due to other factors of tumour, immune cells, or tumour microenvironment

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6
Q

How do immune secluded tumours evade the immune system

A

Immune cells can’t reach tumour, usually due to manipulation of tumour microenvironment

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7
Q

How do immune desert tumours evade the immune system

A

No immune cells, often due to lack of antigens, lack of APCs, or tumour down regulating immune system

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8
Q

How does immunotherapy augment/restore immune system function

A

Killing cancer cells releases contents including antigens
Stimulate APCs
Artificially give antigens via vaccination
Incr T cell number
Make it easier for T cells to infiltrate tumour
Remove cancer cell protection and environment/immune system manipulation

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9
Q

Checkpoint inhibition immunotherapy

A

Block checkpoint inhibition proteins to stop immune system being switched off

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10
Q

Which inhibitory immune system checkpoint receptor is most commonly targeted in cancer therapy

A

PD1

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11
Q

What is the effect of cancer cells binding to PD1 receptors on immune cellso

A

Turn off immune system

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12
Q

What causes upregulation of inhibitory checkpoints on T cells

A

Long term engagement of T cells

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13
Q

How can cancer cells switching off immune responses via binding to PD1 be prevented

A

Drugs targeting PD1 receptors on T cells and PD1 ligands on cancer cells

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14
Q

What do atezolizumab, durvalumab, and avelumab target

A

PD1 ligands on cancer cells

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15
Q

What do pembrolizumab and nivolumab target

A

PD1 receptors on T cells

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16
Q

How are monoclonal antibodies from mice altered so humans don’t develop mouse antibodies

A

Chimerised or humanised

17
Q

What is a chimeric antibody

A

Monoclonal antibody with a large stretch of non human proteins

18
Q

What is a humanised antibody

A

Monoclonal antibody coupled with a human Ig backbone

19
Q

What can monoclonal antibodies be coupled to

A

Toxins
Radioisotopes

20
Q

What is a monoclonal antibody coupled to a toxin or radioisotope called

A

Toxin - Immunotoxin
Radioisotope - radioimmunoconjugate

21
Q

How do unconjugated monoclonal antibodies target cancer cells

A

Complement mediated lysis

22
Q

How do immunotoxins target cancer cells

A

Bind to receptors, are internalised by tumour cells, and inhibit protein synthesis

23
Q

How do radioimmunoconjugates target cancer cells

A

Bind to cell surface receptors, translocate into cells, and damage DNA

24
Q

What is the type of toxin or radioisotope conjugated to a monoclonal antibody chosen based on

A

Cancer type

25
Q

What type of drug is rituximab and what does it target

A

Monoclonal antibody
CD20

26
Q

Which type of cancer does CD20 present on the cell surface of

A

B lymphomas

27
Q

How does blinatumomab force immune system recognition of malignant B cells

A

Targets CD19 on malignant B cells and CD3 on T cells simultaneously bringing them together

28
Q

What is CAR

A

Chimeric antigen receptor

29
Q

What is kymriah/tisagenlecleucel

A

CAR T cell targeting CD19 on B cell lymphomas

30
Q

What viruses can cause cancer

A

Hep B and C
Human T lymphotropic virus
HPV
Kaposis sarcoma associated herpesvirus
Merkle cell polyomavirus
Epstein Barr virus

31
Q

Is immunotherapy most effective in cancers with high or low neoantigen formation

A

Low

32
Q

What age is HPV vaccine given

A

12-13 yrs, 2nd dose 6-24mo after first

33
Q

How can changes to the extracellular matrix caused by tumour cells decrease immune response

A

Prevent immune cell infiltration

34
Q

Adoptive cell transfer

A

Tumour excised, immune cells cultures and assayed for tumour recognition, tumour recognising cells expanded and reinfused

Cancer Y2 (11 decks)

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