Tumor Microenvironment Flashcards

1
Q

Why is a tumour microenvironment important in cancer research?

A

Drugs now target the tME due to the complex cell types present.
Increased CAFs and decreased TILs associated with poor prognosis.
OMIC analyses used to view mutations in malignant cells.

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2
Q

What are the major cell types in the TME?

A
  • CAFs
  • Adipocytes
  • Vasculature cells
  • Immune cells (T, B, NK, Dendritic cells) (TAMs)
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3
Q

What is a fibroblast?

A

Mesechymal cell type that expresses Vimentin as a marker.
Maintains structural integrity of stroma and produces the ECM.
Involved in inflammatory response and homeostasis.

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4
Q

What is a CAF?

A

Cancer associated fibroblast
Major stromal cell type in solid cancers.
Secrete a large amount of ECM proteins, growth factors and cytokines.
Generated through TGFB1 signalling.

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5
Q

How does TGFB1 regulate CAF differentiation?

A

Through a large latent complex, that sits in the ECM until activated by MMPs - cleave it through integrins in cancer cells.
TGFB1 binds TGF receptor - activates SMAD complexes to increase gene transcription and differentiating into CAFs.

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6
Q

Can proteins in the ECM be associated with more aggressive cancers?

A

Collagen rich CAFs are associated with the worst survival rates and most aggressive cancer forms.

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7
Q

The metastatic process steps (5)

A
Invasion
Intravasation
Migration
Extravasation
Colonisation
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8
Q

How can tumour invasion be studied in the lab?

What is the seed and soil hypothesis?

A

Tumour invasion can be studied on a protein gel with fibroblasts to see how far the tumour cells can spread.

The brain, bone, lung and liver are the secondary sites seen most often. ‘Seed and Soil’ hypothesis.

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9
Q

Tumour cell - TGFb1 interaction

A

Tumour cells activate CAF through avB6-dependent activation of TGFb1 – Inhibiting the avB6 cell surface integrin prevents the CAF formation and also prevents invasion.

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10
Q

3 stages of immunoediting

A
  1. Elimination – Immunosurveillance. The innate and adaptive immune systems are active, and the cancer cells are being cleared.
  2. Equilibrium – Persistence. Genetic instability and immunoselection.
  3. Escape – Progression. Positive selection for cancer cells that can escape the immune system and the final progression of cancer.
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11
Q

CD8+ T-cells - function

How TME escapes detection.

A

Recognise antigens on MHC class 1
Express perforin, granzyme and granulysin
T-cells infiltrate the site of the tumour, recognise tumour specific antigens and develop cytotoxic t-cells to kill tumours.
TME will evolve to avoid the immune system.

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12
Q

3 ways secondary resistance can be obtained against the immune system.

A

1 - Insufficient anti-tumour t-cell generation
2 - inadequate anti-tumour t-cell function
3 - impaired formation of t-cell memory

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13
Q

Dysfunction of CD8 cells in tumours

A
  • Hostile environments can deplete nutrients and produce toxic metabolites
  • Suppressive molecules or receptors
  • MHC down regulation
  • Inhibitory t-cell activity receptors (CTLA4)
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14
Q

Regulatory T-cells

A

A subset of CD4+ t-cells that maintain tolerance to self antigens.
Immunosuppressive - suppress production and proliferation of CD8 t cells.
Can be induced by TGFB1
Cause apoptosis of CD8+ and prevent their co-activation.

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15
Q

TAMs

A

Professional phagocytes that are either:
M1 - Classical IFNy pro-inflam, cytotoxic
M2 - Anti-inflam, wound healing, angiogenesis, increased TGFB1
M1 is anti-tumour, M2 is pro-tumour

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16
Q

What are the current main targets for cancer immunotherapy on CD8+ cells?

A

INHIBITORY - CTLA4 & PD1

Activating targets can provide toxic CD8+ effects throughout the body.
Combination therapies of anti-PD1 + anti-CTLA4 drugs have had 58% response rates in patients with metastatic melanomas.

17
Q

How can we predict whether patients will respond to the anti-PD1 drug?

A
  • The immunohistochemical test: drugs, cut-offs and cell scoring.
  • The number of mutations a patient has in their tumours.
    More mutations = more possible recognition of neoantigens and more likely response to drugs.
18
Q

Anti-cancer vaccination strategies

A

Develop vaccines against cancers - tumour specific antigens unique to tumour cells. (viral antigens or new proteins based on mutations in proteins to be presented)

  • tumour associated antigens (misregulated antigens expressed in some cells, where they’re not usually found)
19
Q

How do tumours evade immunotherapy?

A
  • Vaccines can be developed to target tumour specific antigens, which show a decline in tumour growth. However, experiments show that alterations in the TME such as CAF differentiation, hypoxic mutations and GLUT1 transporters can provide mechanisms to evade immunotherapies.
20
Q

What is a CAF differentiation regulation mechanism that can be targeted as an immunotherapy?

A

NOX4 produces ROS. NOX4 inhibitor GKT831 cells reverse back to a normal fibroblast phenotype.