Hallmarks of Cancer Overview

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Questions and Answers

What is the role of telomerase in cancer cells?

  • It leads to genomic instability.
  • It prevents telomere shortening. (correct)
  • It reactivates growth arrest mechanisms.
  • It promotes cellular senescence.

Which protein is typically downregulated in metastatic cancers?

  • VEGF
  • N-cadherin
  • E-cadherin (correct)
  • MYC

What is the main challenge in targeting telomerase for cancer therapy?

  • High expression in normal cells.
  • Availability of telomerase inhibitors.
  • Immediate effects post-inhibition.
  • Slow manifestation of effects. (correct)

Which genes are critical in the process of angiogenesis?

<p>RAS and MYC (B)</p> Signup and view all the answers

How do cancer cells evade immune surveillance?

<p>Through genetic alterations. (A)</p> Signup and view all the answers

What characteristic allows cancer cells to achieve replicative immortality?

<p>Telomerase activation. (B)</p> Signup and view all the answers

Which hallmark of cancer involves reprogramming cellular metabolism?

<p>Deregulating cellular energetics. (A)</p> Signup and view all the answers

What aspect of cancer progression does promoting inflammation contribute to?

<p>Decreased genomic stability. (C)</p> Signup and view all the answers

What is the primary function of tumor suppressor genes (TSGs) in normal cells?

<p>To regulate the cell cycle and prevent excessive cell growth (A)</p> Signup and view all the answers

Which example illustrates the concept of sustained proliferative signaling?

<p>HER2 amplification in metastatic breast cancer (D)</p> Signup and view all the answers

What is a key characteristic of cancer cells in relation to apoptosis?

<p>They alter apoptotic pathways to resist cell death (D)</p> Signup and view all the answers

How do cancer cells typically evade anti-proliferative signaling?

<p>By producing their own growth signals or mutating receptors (C)</p> Signup and view all the answers

Which of the following is an example of a regulator of apoptosis that is often involved in cancer?

<p>Bcl2 (C)</p> Signup and view all the answers

What needs to occur for patients to benefit from Herceptin treatment?

<p>There must be on average twice as many genomic copies of HER2 as chromosome 17 (A)</p> Signup and view all the answers

Which cancer is directly associated with the inactivation of the RB gene?

<p>Retinoblastoma (A)</p> Signup and view all the answers

What is angiogenesis in the context of cancer hallmarks?

<p>Formation of new blood vessels to supply tumors (C)</p> Signup and view all the answers

Which gene is commonly associated with a high percentage of pancreatic cancers?

<p>RAS (A)</p> Signup and view all the answers

What is the ability of cancer cells to spread to other tissues called?

<p>Metastasis (B)</p> Signup and view all the answers

What characterizes cells that have acquired the ability to invade and metastasize?

<p>Loss of cell-cell interactions (A)</p> Signup and view all the answers

Which cadherin is typically upregulated in high grade carcinomas?

<p>N-Cadherin (D)</p> Signup and view all the answers

In the context of cancer, what is a key process that allows malignant cells to escape from the bloodstream into distant tissues?

<p>Local invasion (C)</p> Signup and view all the answers

What hallmark of cancer involves the continuous growth and proliferation of malignant cells?

<p>Cellular energetics deregulation (B)</p> Signup and view all the answers

Which of the following is a potential therapeutic target for cancer that avoids immune destruction?

<p>Immune checkpoint inhibitors (B)</p> Signup and view all the answers

What percentage of breast cancers is associated with activating mutations in RAS?

<p>30% (A)</p> Signup and view all the answers

What HER2 classification indicates that a patient should be prescribed Herceptin?

<p>Classification 3+ (D)</p> Signup and view all the answers

Which patients are not eligible for Herceptin treatment?

<p>Patients classified as 0 or 1+ (A)</p> Signup and view all the answers

What is the purpose of cytogenomic analysis in borderline cases?

<p>To provide a more quantitative assessment of HER2 amplification (D)</p> Signup and view all the answers

What ratio of red to green signals indicates a patient should be considered for Herceptin treatment?

<p>2:1 (D)</p> Signup and view all the answers

Which of the following best explains the function of Herceptin?

<p>It prevents dimerisation of Her2 (A)</p> Signup and view all the answers

Which of the following is a characteristic of normal cells regarding HER2 and chromosome 17 signals?

<p>2 green and 2 red signals (C)</p> Signup and view all the answers

What is commonly altered or suppressed in cancer that leads to loss of function of tumor suppressor genes?

<p>Transcription suppression and methylation (B)</p> Signup and view all the answers

What evidence suggests that a borderline patient is negative for HER2 amplification?

<p>Ratio of red to green signals less than 2 (B)</p> Signup and view all the answers

What is the primary function of the RB protein in normal cells?

<p>Downregulates transcription of genes in cell cycle transitions (D)</p> Signup and view all the answers

Which of the following proteins is known to have anti-apoptotic activity?

<p>BCL2 (C)</p> Signup and view all the answers

Loss of TP53 is associated with which outcome in cancer?

<p>Poor prognosis (B)</p> Signup and view all the answers

What role does TP53 play in cancer biology?

<p>Regulates apoptosis and senses DNA damage (A)</p> Signup and view all the answers

What process is primarily avoided by the loss of RB in cancer cells?

<p>Cell cycle growth suppression (C)</p> Signup and view all the answers

Which gene mutation is found in approximately 50% of all cancers?

<p>TP53 (A)</p> Signup and view all the answers

What happens as a result of the fusion of the BCL2 gene to IGH?

<p>Altered regulation of apoptosis (A)</p> Signup and view all the answers

How do intrinsic and extrinsic pathways differ in apoptosis regulation?

<p>Intrinsic pathways sense internal cell signals (A)</p> Signup and view all the answers

What is the main consequence of clonal expansion in a tumor?

<p>It results in the propagation of a competitive cell line. (D)</p> Signup and view all the answers

Which statement accurately describes the role of BRCA1 and BRCA2 genes in cancer?

<p>They function in the repair of DNA double-strand breaks. (A)</p> Signup and view all the answers

What happens when a tumor exhibits genomic instability?

<p>It becomes empowered to colonize initial sites more effectively. (B)</p> Signup and view all the answers

What characterizes the tumor cell population in highly heterogeneous tumors?

<p>Some clones may dwindle while others may grow in number. (C)</p> Signup and view all the answers

Which aspect increases mutation rates in many cancer cell lines?

<p>Deregulation of DNA damage repair pathways. (C)</p> Signup and view all the answers

How does the inheritance of inactivated BRCA1 or BRCA2 genes affect cancer risk?

<p>It results in a significant increase in the lifetime risk for breast cancer. (D)</p> Signup and view all the answers

What is a consequence of disadvantageous mutations among tumor cells?

<p>They may cause cell death or competitiveness decline. (D)</p> Signup and view all the answers

Which repair pathway is particularly crucial for addressing DNA double-strand breaks during DNA replication in cancer?

<p>Homologous recombination. (C)</p> Signup and view all the answers

Flashcards

TP53 mutation

Mutation of TP53, a gene, is found in about 50% of cancers.

Replicative immortality

Cancer cells bypass normal growth limits to keep dividing indefinitely.

Telomerase activation

Reactivation of telomerase in cancer cells prevents telomere shortening.

Telomere shortening

The process leading to cellular senescence once telomeres are too short.

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Invasion and metastasis

Cancer cells invade tissues and spread via blood or lymphatic systems.

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E-cadherin and N-cadherin

E-cadherin is downregulated while N-cadherin is upregulated in invasive cancers.

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Angiogenesis

The formation of new blood vessels to supply tumors with nutrients and oxygen.

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Deregulating cellular energetics

Cancer cells reprogram their metabolism to support rapid growth.

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Hallmarks of Cancer

Key features driving cancer development, identified in 2000.

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Sustained Proliferative Signaling

Cancer cells produce growth signals or bypass control mechanisms.

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HER2 Amplification

Overexpression of the HER2 receptor in certain breast cancers leads to targeted therapy sensitivity.

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Evasion of Anti-Proliferative Signaling

Cancer cells ignore signals that normally inhibit growth.

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Resisting Cell Death

Cancer cells evade apoptosis, allowing survival despite damage.

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Bcl2 Protein

An anti-apoptotic protein often overexpressed in cancers.

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Tumor Suppressor Genes (TSGs)

Genes that regulate the cell cycle to prevent excessive growth.

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Retinoblastoma

Cancer caused by RB gene inactivation, leading to uncontrolled cell cycle progression.

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RB gene function

RB protein regulates cell cycle by forming complex with E2F to control transcription during G1/S and G2/M transitions.

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Loss of RB in cancer

Downregulation or deletion of RB leads to growth suppression evasion, common in cancer cells.

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Apoptosis evasion

Cancer commonly evades apoptosis, a natural cell death process, through various signaling pathways.

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Intrinsic vs. extrinsic apoptosis pathways

Intrinsic is triggered by internal signals, while extrinsic is triggered by external signals to regulate apoptosis.

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Regulators of apoptosis

Genes that sense apoptotic signals; important for determining if a cell undergoes apoptosis.

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Bcl2 family proteins

Proteins that regulate apoptosis; overactivation is linked to tumorigenesis in cancers.

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TP53 gene function

TP53 senses DNA damage and is a negative regulator of apoptosis; mutated in many cancers.

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BCL2 translocation

BCL2 fused to IGH leads to inappropriate expression and is associated with cancer.

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RAS mutations

Mutations in RAS are linked to several cancers, including pancreatic and bowel cancers.

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Invasion

The process where cancer cells spread to adjacent tissues from the primary tumor.

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Metastasis

The spread of cancer cells to distant organs via blood or lymphatic systems.

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E-Cadherin

A protein that helps cells stick together, often reduced in metastatic cancers.

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N-Cadherin

A protein upregulated in aggressive cancers, aiding cell migration.

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Cellular Energetics

Altered metabolism in cancer, providing energy for growth and division.

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Immune Evasion

Cancer cells avoid destruction by the immune system, aiding their survival.

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Genome Stability Loss

Increased mutations and instability in cancer, leading to more aggressive behavior.

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HER2 gene

A gene that can be amplified in some cancers, influencing treatment with Herceptin.

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Herceptin

A drug prescribed for patients with high HER2 amplification (3+).

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Amplification classification

Assessment of HER2 gene expression levels: 0 (none), 1+ (low), 3+ (high).

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Cytogenomic analysis

A method used to investigate borderline cases of HER2 amplification.

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FISH results

Fluorescence in situ hybridization used to evaluate HER2 amplification status.

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Red to green ratio

A metric used to determine HER2 gene amplification, needing at least 2:1.

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Tumor suppressor genes

Genes that normally restrain cell growth; often mutated or suppressed in cancer.

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Dimerization prevention

What Herceptin does to Her2, stopping cancer signals from spreading.

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Clonal expansion

Propagation of a competitive cell line within a tumor.

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Clonal evolution

Genomic changes that enhance the competitiveness of a tumor clone.

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Genomic instability

Increased mutation rates and chromosomal abnormalities in cancer cells.

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BRCA1 and BRCA2

Tumor suppressor genes linked to breast and ovarian cancer risk.

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Homologous Recombination (HR)

High-fidelity repair pathway for DNA double-strand breaks.

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DNA Damage Repair Pathways

Mechanisms that fix DNA errors to maintain genomic integrity.

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Genotoxic agents

Substances causing damage to DNA, increasing mutation rates.

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High-grade metastatic disease

Aggressive cancer that spreads widely throughout the body.

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Study Notes

Hallmarks of Cancer

  • Cancer is driven by key features, identified in 2000
  • Sustained Proliferative Signaling:
    • Normal cells have tightly controlled division by mitogens and receptors
    • Cancer cells produce their own growth signals, are more sensitive to normal signals, or mutate receptors to be independent of external growth factors
    • Example: HER2 amplification in breast cancer (Herceptin treatment targets this)
  • Evasion of Anti-Proliferative Signaling:
    • Tumor suppressor genes (TSGs) normally regulate cell cycle
    • Cancer cells mutate or silence TSGs, for example TP53 (chromosome 17) and RB (chromosome 13)
    • Example of TSG mutation: Retinoblastoma (RB inactivation)
  • Resisting Cell Death (Evasion of Apoptosis):
    • Apoptosis removes damaged/unneeded cells
    • Cancer cells resist apoptosis by altering apoptotic pathways
    • Example: BCL2 overexpression in B-cell lymphoma inhibits apoptosis
  • Enabling Replicative Immortality:
    • Cancer cells bypass cellular senescence (growth arrest due to short telomeres)
    • Telomerase reactivation in cancer cells prevents telomere shortening, extending their lifespan
  • Activation of Invasion and Metastasis:
    • Cancer cells invade surrounding tissues/spread
    • Involves changes in cell adhesion and motility
  • Angiogenesis:
    • Tumors require blood vessels for nutrient/oxygen supply
    • Cancer cells induce angiogenesis (new blood vessel formation)
    • Example: RAS mutations in many cancers (interact with Her2)

Emerging Hallmarks of Cancer

  • Capabilities identified as playing significant roles in cancer
  • Deregulating Cellular Energetics: Cancer cells reprogram metabolism to support rapid growth
  • Avoiding Immune Destruction: Cancer cells evade immune surveillance (a key area of active research)
  • Promoting Inflammation & Loss of Genome Stability: Contributes to cancer progression

Clonality

  • Cancer involves the accumulation of genetic mutations that provide a competitive advantage
  • These lead to clonal expansion (most competitive cells dominate)
  • Clonal evolution is a hallmark of aggressive cancers

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