SM_281b: Tumor Immunology Flashcards

1
Q

____ is the backbone of current treatment regimens for cancer

A

Chemotherapy is the backbone of current treatment regimens for cancer

  • Relatively nonspecific cytotoxic agents
  • Low likelihood of durable response
  • Limited by narrow therapeutic index, significant toxicities, frequently acquired resistance
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2
Q

Targeted therapies for cancer aim to ___ and modulate ___

A

Targeted therapies for cancer aim to inhibit molecular pathways crucial for tumor growth and maintenance and modulate immune responses

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3
Q

Immunotherapy elicits a ___

A

Immunotherapy elicits a durable anti-tumor response

  • Immunotherapy is a living drug
  • Immune system can evolve to treat the tumor
  • Immunotherapy can cure some cancers
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4
Q

Describe the cancer-immunity cycle

A

Cancer-immunity cycle

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5
Q

Describe the innate immune system

A

Innate immune system

  • Non-spcific
  • No need for antigens
  • No memory
  • Immediate response
  • Transient duration
  • Tissue repair
  • Macrophages, dendritic cells, NK cells, neutrophils
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6
Q

Describe the adaptive immune system

A

Adaptive immune system

  • Specific
  • Require antigens
  • Memory is generated
  • Slow response
  • LIfelong duration
  • T cells, B cells
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7
Q

Describe integration of innate and adaptive immunity

A

Integration of innate and adaptive immunity

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8
Q

Neutrophils are involved in ___ and secrete ___

A

Neutrophils are involved in phagocytosis and debris clean up and secrete chemokines

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9
Q

Dendritics cells are potent ___ that ___

A

Dendritics cells are potent antigen-presenting cells that uptake process antigens

  • Both class I and class II pathways
  • Will stimulate cytotoxic T and T helper cells
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10
Q

Macrophages are involved in ___ and secrete ___

A

Macrophages are involved in phagocytosis and debris clean up and secrete cytokines

  • Type I can turn on adaptive immunity
  • Type II will limit adaptive immunity
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11
Q
A
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12
Q

Natural killer cells can ___ and secrete high levels of ___

A

Natural killer cells can directly kill tumor without docking to MHC and secrete high levels of IFN-gamma

  • Antibodies can activate them via FC receptor
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13
Q

B lymphocytes are involved in ___

A

B lymphocytes are involved in humoral immunity

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14
Q

T lymphocytes are involved in ___

A

T lymphocytes are involved in cellular immunity

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15
Q

Immune surveillance involves ___

A

Immune surveillance involves tumor specific antigens recognized by CD8+ T cells

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16
Q

___ are the critical link between innate and adaptive immunity

A

Dendritic cells are the critical link between innate and adaptive immunity

  • Activation
  • Proliferation
  • CTL generation
17
Q

There are checks and balances between ___ and ___

A

There are checks and balances between tumor regression and tumor progression

18
Q

Tumor regression involves the cytokines ____, ____, ____, and ____

A

Tumor regression involves the cytokines IL-12, IL-2, IFN-gamma, and TNF-alpha

19
Q

Tumor progression involves the cytokines ___, ___, ___, and ___

A

Tumor progression involves the cytokines IL-4, IL-5, IL-10, and TGF-beta

20
Q

Describe immunotherapies for cancer

A

Immunotherapies for cancer

  • Cytokines / immune stimulants: interferon (alpha, beta, gamma), IL-2
  • Monoclonal antibodies: many targets in multiple malignancies
  • Vaccines: stimulate immune response against autologous tumor / peptides, enhances endogenous immunity to fight cancer, sipuleucel-T for prostate cancer
  • Oncolytic virus
  • Gene therapy / cellular therapy: replace defective mutant allele (hereditary disease) with a functional zone
  • Chimeric antigen receptor (CAR) T cells
21
Q

Checkpoint inhibition ___

A

Checkpoint inhibition increases T cell activation

22
Q

Checkpoint inhibition via ____ and ____ increases T cell activation

A

Checkpoint inhibition via anti-PD-1 and anti-CTLA-4 antibodies increases T cell activation

23
Q

___, ___, and ___ are anti-PD-1 antibodies for checkpoint inhibition

A

Nivolumab, pembrolizumab, and cemiplimab are anti-PD-1 antibodies for checkpoint inhibition

24
Q

____ is an anti-CTLA-4 antibody for checkpoint inhibition

A

Ipilimumab is an anti-CTLA-4 antibody for checkpoint inhibition

25
Q

Antibody mediated targeting of ___

A

Antibody mediated targeting of negative regulators of T cell responses

26
Q

Priming phase with CTLA-4 occurs in the ___, while the effector phase with PD-1 occurs in the ___

A

Priming phase with CTLA-4 occurs in the lymph node, while the effector phase with PD-1 occurs in the tumor microenvironment

  • Biologic rationale for combined CTLA-4 and PD-1 blockade
27
Q

___ and ___ improve overall survival in melanoma

A

Ipilimumab and nivolumab improve overall survival in melanoma

28
Q

___ is an oncolytic virus used to treat melanoma

A

Talimogene laherparepvec is an oncolytic virus used to treat melanoma

29
Q

___ is an atypical response that can occur with immunotherapies

A

Pseudoprogression is an atypical response that can occur with immunotherapies

30
Q

____ is an anti-PD1 used for cutaneous squamous cell carcinoma

A

Cemiplimab is an anti-PD1 used for cutaneous squamous cell carcinoma

31
Q

Describe immune-mediated dermatologic toxicities

A

Immune-mediated dermatologic toxicities

  • Rash
  • Pustular psoriasis
  • Lichen planus
  • Anti-PD-1 induced demartomyositis
  • Anti-PD1 and anti-CTLA-4 induced subacute cutaneous lupus erythematosus
32
Q

Describe adverse events of cancer immunotherapies

A

Adverse events of cancer immunotherapies

  • Dermatologic toxicities
  • Immune mediated colitis
  • Hypophysitis
  • Pneumonitis
  • Transverse myelitis
  • Encephalitis
33
Q

___ can cause dyspnea and hypoxemic respiratory failure

A

Ipilimumab and novolumab can cause dyspnea and hypoxemic respiratory failure

34
Q

Checkpoint blockade sometimes ___

A

Checkpoint blockade sometimes does not work