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
What type of drug is rituximab and what does it target
Monoclonal antibody CD20
26
Which type of cancer does CD20 present on the cell surface of
B lymphomas
27
How does blinatumomab force immune system recognition of malignant B cells
Targets CD19 on malignant B cells and CD3 on T cells simultaneously bringing them together
28
What is CAR
Chimeric antigen receptor
29
What is kymriah/tisagenlecleucel
CAR T cell targeting CD19 on B cell lymphomas
30
What viruses can cause cancer
Hep B and C Human T lymphotropic virus HPV Kaposis sarcoma associated herpesvirus Merkle cell polyomavirus Epstein Barr virus
31
Is immunotherapy most effective in cancers with high or low neoantigen formation
Low
32
What age is HPV vaccine given
12-13 yrs, 2nd dose 6-24mo after first
33
How can changes to the extracellular matrix caused by tumour cells decrease immune response
Prevent immune cell infiltration
34
Adoptive cell transfer
Tumour excised, immune cells cultures and assayed for tumour recognition, tumour recognising cells expanded and reinfused