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Questions and Answers

What is the primary component of the basement membrane that tumor cells interact with during invasion?

  • Laminin (correct)
  • Collagen
  • Elastic fibers
  • Proteoglycans

    • Which of the following is NOT a function of adhesion molecules in tumor cells?

  • Cell-cell adhesion
  • Cell-matrix adhesion
  • Inhibition of apoptosis
  • Induction of angiogenesis (correct)

    • What is the term for the process by which tumor cells escape from the primary tumor site and enter the bloodstream or lymphatic vessels?

  • Dissemination (correct)
  • Metastasis
  • Invasion
  • Homing

    • Which of the following is a type of paracrine effector that promotes tumor cell motility?

    <p>Chemokines</p> Signup and view all the answers

    What is the term for the process by which tumor cells recruit blood vessels to the primary tumor site?

    <p>Angiogenesis</p> Signup and view all the answers

    Which of the following is NOT a component of the extracellular matrix?

    <p>Cytoskeleton</p> Signup and view all the answers

    What is the term for the process by which tumor cells adhere to the endothelial lining of blood vessels during metastasis?

    <p>Homing</p> Signup and view all the answers

    Which of the following is a type of cell that can produce factors that promote tumor cell motility?

    <p>Stromal cells</p> Signup and view all the answers

    What is the primary mechanism by which tumor cells spread and grow?

    <p>Intravasation into vascular beds and invasion of normal tissues</p> Signup and view all the answers

    Why are tumor cells vulnerable to destruction by immune cells?

    <p>As a result of their circulation in the bloodstream</p> Signup and view all the answers

    What is the outcome of tumor cells interacting with host immune cells?

    <p>Tumor cells may grow or be suppressed depending on the host immune response</p> Signup and view all the answers

    Why is intravasation into vascular beds important for tumor cell spread?

    <p>It is necessary for tumor cell invasion of normal tissues</p> Signup and view all the answers

    What is the role of extravasation in tumor cell spread?

    <p>It is a secondary mechanism that occurs after intravasation</p> Signup and view all the answers

    How do tumor cells interact with host immune cells?

    <p>Through a combination of these mechanisms</p> Signup and view all the answers

    What is the outcome of tumor cells invading normal tissues?

    <p>Tumor cells may grow or be suppressed depending on the tissue microenvironment</p> Signup and view all the answers

    Why is the primary tumor site important for tumor cell growth and spread?

    <p>It provides stromal support for tumor cell growth</p> Signup and view all the answers

    What is the likely outcome of having germ line mutations in BRCA2?

    <p>Increased risk of breast cancer</p> Signup and view all the answers

    What is the role of BRCA1 and BRCA2 in cancer development?

    <p>Tumor suppressors</p> Signup and view all the answers

    What is the characteristic of Hereditary Nonpolyposis Colon Cancer (HNPCC) syndrome?

    <p>No polyps in the colon</p> Signup and view all the answers

    What is the consequence of somatic mutations in DNA repair genes?

    <p>Increased risk of cancer</p> Signup and view all the answers

    What is the role of DNA mismatch repair genes in cancer development?

    <p>DNA repair genes</p> Signup and view all the answers

    What is the effect of inactivating BRCA1 and BRCA2 genes?

    <p>Inactivation of DNA repair machinery</p> Signup and view all the answers

    What is the relationship between germ line mutations in BRCA2 and cancer risk?

    <p>Direct relationship</p> Signup and view all the answers

    What is the consequence of Tumor-Promoting Inflammation in cancer development?

    <p>Increased cancer risk</p> Signup and view all the answers

    Which of the following checkpoint inhibitors is used to avoid immune destruction?

    <p>Anti-CTLA-4</p> Signup and view all the answers

    What is the main function of BCL2 inhibitors in cancer treatment?

    <p>To resist cell death</p> Signup and view all the answers

    Which of the following signaling pathways is deregulated in cancer cells to promote growth?

    <p>Proliferative signaling</p> Signup and view all the answers

    What is the main function of MDM2 inhibitors in cancer treatment?

    <p>To reactivate p53</p> Signup and view all the answers

    Which of the following is a hallmark of cancer?

    <p>All of the above</p> Signup and view all the answers

    What is the main function of PARP inhibitors in cancer treatment?

    <p>To induce genome instability and mutation</p> Signup and view all the answers

    Which of the following is a type of inhibitor used to treat cancer?

    <p>All of the above</p> Signup and view all the answers

    What is the main function of VEGF inhibitors in cancer treatment?

    <p>To inhibit angiogenesis</p> Signup and view all the answers

    Which of the following is a hallmark of cancer that allows cancer cells to continue to grow and divide?

    <p>Enabling replicative immortality</p> Signup and view all the answers

    What is the main function of anti-CTLA-4 in cancer treatment?

    <p>To avoid immune destruction</p> Signup and view all the answers

    What role do paraneoplastic syndromes play in cancer patients?

    <p>They may occur despite the tumor's local or distant spread.</p> Signup and view all the answers

    How does the activation of macrophages relate to tumor necrosis?

    <p>They release TNF, which contributes to inflammation and tumor behavior.</p> Signup and view all the answers

    What is the significance of grading tumors?

    <p>It assesses how aggressive a neoplasm is.</p> Signup and view all the answers

    What is a common outcome of the release of free fatty acids in cancer progression?

    <p>Inhibition of immune responses against tumors.</p> Signup and view all the answers

    What is the significance of cytokines in assessing cancer stage?

    <p>They help to determine the level of invasiveness of cancer.</p> Signup and view all the answers

    Why are clinical and radiologic studies important in tumor evaluation?

    <p>They play a role in grading tumors based on histological features.</p> Signup and view all the answers

    What is one reason tumor grades are considered more informative than tumor stages?

    <p>They often indicate the prognostic outcome better.</p> Signup and view all the answers

    What is an implication of cytokine action in relation to tumor cells?

    <p>They can influence the immune system's response to tumors.</p> Signup and view all the answers

    Tumor cells are resistant to destruction by immune cells.

    <p>False</p> Signup and view all the answers

    Tumor cells grow rapidly in the primary tumor site due to the suppression by resident immune cells.

    <p>False</p> Signup and view all the answers

    Extravasation into vascular beds is a crucial step for tumor cell motility.

    <p>False</p> Signup and view all the answers

    Intravasation into vascular beds is a process that occurs only in late-stage tumors.

    <p>False</p> Signup and view all the answers

    Tumor cells always grow rapidly in the primary tumor site without any suppression by immune cells.

    <p>False</p> Signup and view all the answers

    The primary tumor site is not important for tumor cell growth and spread.

    <p>False</p> Signup and view all the answers

    Tumor cells can escape from immune cells only through intravasation into vascular beds.

    <p>False</p> Signup and view all the answers

    Tumor cells are always supported by stromal support in the primary tumor site.

    <p>False</p> Signup and view all the answers

    Extravasation of tumor cells into vascular beds is a process that occurs only in late-stage tumors.

    <p>False</p> Signup and view all the answers

    Tumor cells always grow rapidly in the primary tumor site without any suppression by immune cells.

    <p>False</p> Signup and view all the answers

    Intravasation into vascular beds is essential for tumor cell motility.

    <p>True</p> Signup and view all the answers

    Tumor cells are always supported by stromal support in the primary tumor site.

    <p>False</p> Signup and view all the answers

    Adhesion molecules are involved in the process of extravasation of tumor cells into vascular beds.

    <p>True</p> Signup and view all the answers

    Metastatic tumors always form in distant organs with similar tissue structure to the primary tumor site.

    <p>False</p> Signup and view all the answers

    The primary tumor site is not important for tumor cell growth and spread.

    <p>False</p> Signup and view all the answers

    Tumor cells can escape from immune cells only through intravasation into vascular beds.

    <p>False</p> Signup and view all the answers

    The host immune system is always capable of destroying tumors.

    <p>False</p> Signup and view all the answers

    Tumor cells can only spread through the lymphatic vessels.

    <p>False</p> Signup and view all the answers

    The primary tumor site is not important for tumor cell growth and spread.

    <p>False</p> Signup and view all the answers

    Immune cells always support tumor cell growth and spread.

    <p>False</p> Signup and view all the answers

    Tumor cells can only evade immune cells through intravasation into vascular beds.

    <p>False</p> Signup and view all the answers

    Tumor cells grow rapidly in the primary tumor site due to the suppression by resident immune cells.

    <p>False</p> Signup and view all the answers

    Extravasation into vascular beds is a process that occurs only in late-stage tumors.

    <p>False</p> Signup and view all the answers

    Tumor cells are resistant to destruction by immune cells due to their genetic mutations.

    <p>False</p> Signup and view all the answers

    Activation of BAX/BAK may be stimulated by antiangiogenic factors.

    <p>False</p> Signup and view all the answers

    Cytokines produced by macrophages are involved in the promotion of tumor angiogenesis.

    <p>True</p> Signup and view all the answers

    BCL-2 and its relatives are known to inhibit apoptosis in tumor cells.

    <p>True</p> Signup and view all the answers

    Tumor-associated macrophages exclusively aid in immune defense against cancer cells.

    <p>False</p> Signup and view all the answers

    Mitochondrial factors released by tumors can influence proangiogenic activity.

    <p>True</p> Signup and view all the answers

    Proangiogenic factors are primarily produced by normal resident cells in the tissue.

    <p>False</p> Signup and view all the answers

    The activation of stromal cells is essential for the progression of tumor angiogenesis.

    <p>True</p> Signup and view all the answers

    The role of proapoptotic proteins is to promote cell survival in tumors.

    <p>False</p> Signup and view all the answers

    The presence of functional CD8+ T cells is a strong predictor of cancer survival.

    <p>True</p> Signup and view all the answers

    The immune system is always capable of recognizing and eliminating nascent cancers.

    <p>False</p> Signup and view all the answers

    The "immunoscore", which quantifies the immune cell infiltration in a tumor, has no predictive value for cancer survival.

    <p>False</p> Signup and view all the answers

    The presence of "invisible" tumors that are not detectable by the immune system is a common occurrence.

    <p>True</p> Signup and view all the answers

    The understanding of immune evasion mechanisms has led to a revolution in cancer therapy, with the development of "immunotherapies".

    <p>True</p> Signup and view all the answers

    The exact role of immune cells, like macrophages and NK cells, in cancer progression is well understood.

    <p>False</p> Signup and view all the answers

    What is the significance of receptors on the surface of tumor cells in regards to metastatic behavior?

    <p>The presence of receptors on the surface of tumor cells allows them to interact with the microenvironment and supports their growth and metastasis.</p> Signup and view all the answers

    How do adhesion molecules contribute to the extravasation of tumor cells?

    <p>Adhesion molecules facilitate the binding of tumor cells to the endothelial lining of blood vessels, allowing them to extravasate and invade secondary tissues.</p> Signup and view all the answers

    What is the role of the microenvironment in supporting the growth and spread of tumor cells?

    <p>The microenvironment provides tumor cells with growth factors, nutrient supply, and mechanical support, promoting their growth and spread.</p> Signup and view all the answers

    How do tumor cells interact with the stroma to promote their growth and invasion?

    <p>Tumor cells interact with the stroma through paracrine signaling, producing chemokines and growth factors that recruit stromal cells and promote their growth and invasion.</p> Signup and view all the answers

    What is the significance of the deposit of tumor cells in secondary tissues?

    <p>The deposit of tumor cells in secondary tissues allows them to establish metastatic colonies, leading to the spread of cancer.</p> Signup and view all the answers

    How do tumor cells modulate the immune response to promote their growth and survival?

    <p>Tumor cells modulate the immune response by producing immunosuppressive factors, such as TGF-β, and by recruiting immune cells that promote their growth and survival.</p> Signup and view all the answers

    What is the role of chemokines in promoting the migration and invasion of tumor cells?

    <p>Chemokines attract tumor cells to secondary tissues, promoting their migration and invasion.</p> Signup and view all the answers

    How do tumor cells interact with the extracellular matrix to promote their growth and invasion?

    <p>Tumor cells interact with the extracellular matrix by producing matrix metalloproteinases, which degrade the matrix and allow them to invade and migrate.</p> Signup and view all the answers

    What is the role of CD28 in the process of costimulation?

    <p>CD28 provides a costimulatory signal that activates T cells.</p> Signup and view all the answers

    How do checkpoint inhibitors like CTLA-4 and PD-1 affect T cell activation?

    <p>Checkpoint inhibitors like CTLA-4 and PD-1 inhibit T cell activation by blocking costimulatory signals.</p> Signup and view all the answers

    What is the role of dendritic cells in presenting antigens to T cells?

    <p>Dendritic cells process and present antigens to T cells through MHC molecules.</p> Signup and view all the answers

    What is the outcome of T cells interacting with tumor cells in the absence of costimulation?

    <p>T cells become inhibited or anergic.</p> Signup and view all the answers

    What is the purpose of anti-CTLA-4 therapy in cancer treatment?

    <p>To enhance T cell activation and anti-tumor immunity.</p> Signup and view all the answers

    How do PD-1 ligands on tumor cells affect T cell activation?

    <p>PD-1 ligands bind to PD-1 on T cells, reducing their activation and immune response.</p> Signup and view all the answers

    What is the role of primed cytotoxic T cells in anti-tumor immunity?

    <p>Primed cytotoxic T cells recognize and kill tumor cells.</p> Signup and view all the answers

    How do tumor cells evade immune detection?

    <p>Tumor cells can evade immune detection by expressing immune checkpoint molecules and inhibiting T cell activation.</p> Signup and view all the answers

    What is the purpose of anti-PD-1 therapy in cancer treatment?

    <p>To enhance T cell activation and anti-tumor immunity.</p> Signup and view all the answers

    How do T cells recognize and kill tumor cells?

    <p>T cells recognize tumor cells through antigen presentation and kill them through the release of cytotoxic granules.</p> Signup and view all the answers

    How do checkpoint inhibitors, such as anti-CTLA-4 and anti-PD-1/PD-L1, contribute to cancer treatment?

    <p>Checkpoint inhibitors allow the immune system to recognize and attack cancer cells by blocking inhibitory signals.</p> Signup and view all the answers

    What is the role of MDM2 inhibitors in cancer treatment, and how do they relate to the function of p53?

    <p>MDM2 inhibitors prevent the degradation of p53, allowing it to activate its tumor suppressor functions and induce cell cycle arrest or apoptosis.</p> Signup and view all the answers

    Describe the role of BCL2 inhibitors in cancer treatment, and how they relate to the regulation of apoptosis.

    <p>BCL2 inhibitors promote apoptosis by blocking the anti-apoptotic function of BCL2, allowing cancer cells to undergo programmed cell death.</p> Signup and view all the answers

    What is the significance of the EGFR signaling pathway in cancer cells, and how do its inhibitors contribute to cancer treatment?

    <p>The EGFR signaling pathway regulates cell proliferation and survival in cancer cells. Its inhibitors block this pathway, inducing cell cycle arrest and apoptosis.</p> Signup and view all the answers

    How do PARP inhibitors contribute to cancer treatment, and what is their relationship to DNA repair mechanisms?

    <p>PARP inhibitors block the repair of DNA damage in cancer cells, making them more susceptible to chemotherapy and radiation.</p> Signup and view all the answers

    What is the role of VEGF inhibitors in cancer treatment, and how do they relate to angiogenesis?

    <p>VEGF inhibitors block the formation of new blood vessels, starving cancer cells of oxygen and nutrients and inhibiting their growth.</p> Signup and view all the answers

    Describe the relationship between tumor-promoting inflammation and cancer development.

    <p>Tumor-promoting inflammation creates an environment that supports the growth and survival of cancer cells, promoting their development and progression.</p> Signup and view all the answers

    What is the significance of sustaining proliferative signaling in cancer cells, and how do its inhibitors contribute to cancer treatment?

    <p>Sustaining proliferative signaling allows cancer cells to continue to grow and divide. Inhibitors of this pathway block this signaling, inducing cell cycle arrest or apoptosis.</p> Signup and view all the answers

    How do inhibitors of genome instability and mutation contribute to cancer treatment, and what is their relationship to DNA repair mechanisms?

    <p>Inhibitors of genome instability and mutation block the ability of cancer cells to mutate and adapt, making them more susceptible to cancer treatments.</p> Signup and view all the answers

    Describe the role of evading growth suppressors in cancer development, and how do its inhibitors contribute to cancer treatment?

    <p>Evading growth suppressors allows cancer cells to escape the normal mechanisms that regulate cell growth and division. Inhibitors of this process block this evasion, inducing cell cycle arrest or apoptosis.</p> Signup and view all the answers

    Explain how defects in DNA repair systems, specifically homologous recombination repair, contribute to the development of cancer, using the examples of BRCA1 and BRCA2.

    <p>Defects in DNA repair systems, such as homologous recombination repair, increase the risk of cancer development. These systems are crucial for fixing DNA damage, which can occur due to environmental factors or during normal cell processes. BRCA1 and BRCA2 are genes involved in homologous recombination repair. Mutations in these genes can disrupt the repair process, leading to an accumulation of DNA damage, particularly double-strand breaks. This unrepaired damage can lead to mutations in other genes that control cell growth and division, promoting tumor formation.</p> Signup and view all the answers

    Describe the role of germline mutations in DNA repair genes, such as BRCA1 and BRCA2, in the predisposition to cancer.

    <p>Germline mutations in DNA repair genes, such as BRCA1 and BRCA2, are inherited mutations present in all cells of an individual. These mutations increase the risk of developing cancer because they affect the function of DNA repair mechanisms from the very beginning of life. As a result, cells with these mutations are more susceptible to accumulating DNA damage that can lead to uncontrolled cell growth and tumor formation. These mutations can cause inherited cancer syndromes, such as hereditary breast and ovarian cancer syndrome, where individuals have a significantly higher chance of developing these cancers.</p> Signup and view all the answers

    Explain the link between defective homologous recombination repair and the increased risk of breast cancer.

    <p>Defective homologous recombination repair, particularly mutations in genes like BRCA1 and BRCA2, is strongly associated with an increased risk of breast cancer. This is because these genes are crucial for repairing double-strand breaks in DNA, which are a common type of DNA damage. When these repair mechanisms are compromised, the accumulation of unrepaired DNA damage can lead to mutations in genes that regulate cell growth and division. These mutations can then promote the development of breast cancer. Studies have shown that individuals with germline mutations in BRCA1 or BRCA2 have a significantly higher risk of developing breast cancer compared to the general population.</p> Signup and view all the answers

    Why are defects in DNA repair pathways, such as homologous recombination, a significant factor in cancer development? Discuss the role of these pathways in maintaining genomic integrity.

    <p>DNA repair pathways, including homologous recombination, are essential for maintaining genomic integrity by correcting DNA damage that can arise from various sources, such as exposure to environmental toxins, replication errors, or reactive oxygen species. Defects in these pathways can lead to the accumulation of unrepaired DNA damage, which can result in mutations that drive cancer development. Homologous recombination is particularly important for repairing double-strand breaks in DNA, a type of damage that is highly mutagenic and can lead to chromosome instability. Defective homologous recombination repair can also disrupt other cellular processes like cell cycle control and apoptosis, further contributing to cancer progression.</p> Signup and view all the answers

    What is the relationship between DNA repair defects and the development of cancer syndromes, such as hereditary breast and ovarian cancer syndrome? How do these syndromes differ from sporadic cancers?

    <p>DNA repair defects, particularly germline mutations in genes involved in homologous recombination repair, such as BRCA1 and BRCA2, are the underlying cause of cancer syndromes like hereditary breast and ovarian cancer syndrome. These syndromes are characterized by a significantly increased risk of developing specific cancers due to the inherited predisposition to DNA damage accumulation. Sporadic cancers, on the other hand, are not inherited and arise from somatic mutations that occur during a person's lifetime. While sporadic cancers can also involve DNA repair defects, they are not inherited and typically occur later in life. The key difference is that individuals with cancer syndromes have a genetic predisposition to cancer due to germline mutations in genes involved in fundamental cellular processes, such as DNA repair.</p> Signup and view all the answers

    How do defects in DNA repair systems contribute to the development of a higher risk of ovarian carcinoma and other cancers?

    <p>Defects in DNA repair systems, especially those involved in homologous recombination repair like BRCA1 and BRCA2, can lead to an increased risk of developing ovarian carcinoma and other cancers. These defects make cells more susceptible to accumulating DNA damage, which can lead to mutations in genes that control cell growth and division. These mutations can then promote the development of various cancers. Individuals with germline mutations in BRCA1 or BRCA2 have a significantly higher risk of developing not only breast cancer but also ovarian carcinoma, fallopian tube cancer, and other cancers. These mutations highlight the crucial role of DNA repair in maintaining genomic integrity and preventing cancer.</p> Signup and view all the answers

    Discuss the impact of DNA repair defects on the development of both inherited and sporadic cancers. Explain how these defects contribute to the accumulation of mutations and tumorigenesis.

    <p>DNA repair defects can contribute to both inherited and sporadic cancers. Inherited defects, often caused by germline mutations in DNA repair genes, are present from birth and increase the risk of developing specific cancers. These mutations make cells more susceptible to DNA damage accumulation, which can lead to mutations in genes that regulate cell growth and division, ultimately promoting tumorigenesis. Sporadic cancers, on the other hand, arise from somatic mutations that occur during a person's lifetime. While these mutations can also affect DNA repair genes, they are not inherited. However, DNA repair defects in both inherited and sporadic cancers can contribute to the accumulation of mutations and tumorigenesis by disrupting the ability of cells to repair DNA damage. This can lead to genomic instability, a hallmark of cancer, and drive the development of tumors.</p> Signup and view all the answers

    Why are women with BRCA1 mutations at a higher risk of developing both breast and ovarian cancer? Discuss the underlying mechanism and the role of these genes in DNA repair.

    <p>Women with BRCA1 mutations are at a higher risk of developing both breast and ovarian cancer due to the critical role of BRCA1 in DNA repair, specifically homologous recombination repair. BRCA1 is involved in repairing double-strand breaks in DNA, a type of damage that can be highly mutagenic and lead to chromosome instability. When BRCA1 is mutated, the repair process is disrupted, leading to the accumulation of unrepaired DNA damage. This damage can lead to mutations in genes that control cell growth and division, promoting tumor development. Mutations in BRCA1 increase the risk of both breast and ovarian cancer because these tissues are particularly prone to accumulating DNA damage due to their high rates of cell division and exposure to hormones. Furthermore, BRCA1 plays a role in regulating the cell cycle, ensuring that cells only divide when appropriate. Mutations in BRCA1 can disrupt this regulation, allowing cells with unrepaired DNA damage to continue dividing, further contributing to tumor growth.</p> Signup and view all the answers

    What mechanism is associated with Cushing syndrome in small cell lung carcinoma?

    <p>ACTH or ACTH-like substance</p> Signup and view all the answers

    Which neoplasm is commonly associated with hypercalcemia?

    <p>Squamous cell lung carcinoma</p> Signup and view all the answers

    What is one immunologic mechanism related to myasthenia associated with lung carcinoma?

    <p>Immunologic mechanism</p> Signup and view all the answers

    What substance is commonly secreted in relation to the Trousseau phenomenon?

    <p>Tumor products that activate clotting factors</p> Signup and view all the answers

    Which tumor type is associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH)?

    <p>Small cell lung carcinoma</p> Signup and view all the answers

    Name a neoplasm associated with hypoglycemia due to insulin-like substances.

    <p>Fibrosarcoma</p> Signup and view all the answers

    What dermatologic disorder is linked to gastric carcinoma?

    <p>Acanthosis nigricans</p> Signup and view all the answers

    What immunologic mechanism is associated with red cell aplasia and thymoma?

    <p>Immunologic</p> Signup and view all the answers

    Which tumor type can lead to polycythemia due to increased erythropoietin production?

    <p>Renal cell carcinoma</p> Signup and view all the answers

    Which two types of neoplasms commonly exhibit immunologic disorders of the central nervous system?

    <p>Breast carcinoma and Teratoma</p> Signup and view all the answers

    However, ___________ angiogenesis has not been as extensively studied as or gnostic anymore; presumably, subordinate cones of or

    <p>ver</p> Signup and view all the answers

    As discussed previously in the context of cellular aging (see Chapter 1), most normal ___________ cells can double 60 to 70 times, after which blood vessels emerge, thereby sedating the need for

    <p>human</p> Signup and view all the answers

    Cells those the ability to divide and enter ___________, thereby preventing the need for

    <p>senescence</p> Signup and view all the answers

    Blocking _______ or CTLA-4 with antibodies leads to primed CTL capable of killing tumor cells.

    <p>PD-1</p> Signup and view all the answers

    This phenomenon is neo ___________ due to progressive shortening of telomeres at the ends of chromosomes.

    <p>angiogenes</p> Signup and view all the answers

    Dendritic cells present tumor _______-MHC to CD8+ T cells.

    <p>peptide</p> Signup and view all the answers

    The consequences of telomere shortening, when pronounced, are ___________.

    <p>drastic</p> Signup and view all the answers

    CTLA-4 is a molecule that inhibits the activity of _______ cells.

    <p>T</p> Signup and view all the answers

    CD28 is a _______ molecule that activates T cells.

    <p>costimulatory</p> Signup and view all the answers

    Invasion and ___________ are the most critical aspects of cancer progression.

    <p>Metastasis</p> Signup and view all the answers

    Anti-PD-1 therapy leads to the killing of _______ cells.

    <p>tumor</p> Signup and view all the answers

    Tumor cells interact with the host ___________ cells, leading to the destruction of tumor cells.

    <p>immune</p> Signup and view all the answers

    The primary tumor site is important for tumor cell ___________ and spread.

    <p>growth</p> Signup and view all the answers

    In the absence of _______ , CD8+ T cells are inhibited.

    <p>costimulation</p> Signup and view all the answers

    PD-1 ligand is expressed on _______ cells.

    <p>tumor</p> Signup and view all the answers

    CD8+ CTL granules contain molecules that kill _______ cells.

    <p>tumor</p> Signup and view all the answers

    Blocking PD-1 or CTLA-4 can lead to the activation of _______ cells.

    <p>cytotoxic</p> Signup and view all the answers

    Anti-CTLA-4 therapy leads to the activation of _______ cells.

    <p>CD8+</p> Signup and view all the answers

    In many patients, loss of ______ has been associated with poor outcome.

    <p>E-cadherin</p> Signup and view all the answers

    [Blank] and quality of immune responses are often correlated with cancer outcome.

    <p>exemptions</p> Signup and view all the answers

    Upregulation of ______ genes are more typical of mesenchymal cells.

    <p>genes</p> Signup and view all the answers

    There is an increased incidence of certain cancers in ______ deficiency states.

    <p>immune</p> Signup and view all the answers

    Recent studies have shown that therapies that simulate ______ are effective against certain cancers.

    <p>immune</p> Signup and view all the answers

    EMT is often accompanied by ______ of the basement membrane.

    <p>local degradation</p> Signup and view all the answers

    Tumor cells often acquire ______ changes, leading to a more invasive phenotype.

    <p>epigenetic</p> Signup and view all the answers

    EMT is characterized by the loss of ______ and the gain of mesenchymal traits.

    <p>E-cadherin</p> Signup and view all the answers

    However, ______ patients

    <p>in</p> Signup and view all the answers

    These genes are unstable and ______ or decrease in

    <p>increase</p> Signup and view all the answers

    HNPCC syndrome accounts for only 2% to 4% of all ______ cancers, but MSI can be detected in about 15% of sporadic cancers.

    <p>colorectal</p> Signup and view all the answers

    In this respect, they resemble ______ genes.

    <p>tumor suppressor</p> Signup and view all the answers

    Tumors, producing enzymes that enhance ______ tumor invasion and

    <p>local</p> Signup and view all the answers

    Tumors, producing enzymes that enhance local tumor invasion and ______ metastasis.

    <p>metastatic</p> Signup and view all the answers

    Benign and malignant tumors may cause local and systemic problems through a variety of direct and indirect ______.

    <p>effects</p> Signup and view all the answers

    The ______ or by the elaboration of hormones indigenous to the tissue of origin of the tumor

    <p>tumor</p> Signup and view all the answers

    They may be the earliest manifestation of an occult neoplasm and their clinical recognition is important for several ______.

    <p>reasons</p> Signup and view all the answers

    Anamorphic location is a crucial determinant of the local, "space-occupying" ______ of both benign and malignant tumors.

    <p>effects</p> Signup and view all the answers

    Therapies approved for use or in advanced clinical ______ are listed.

    <p>trials</p> Signup and view all the answers

    The hallmarks of cancer: the next ______.

    <p>generation</p> Signup and view all the answers

    Therapeutic targeting of hallmarks of ______.

    <p>cancer</p> Signup and view all the answers

    They appear in 10% to 15% of cancer ______.

    <p>patients</p> Signup and view all the answers

    Match the following cancer-related processes with their correct descriptions:

    <p>Intravasation = Entry of tumor cells into the bloodstream Extravasation = Exit of tumor cells from the bloodstream Destruction by immune cells = Targeting of tumor cells by host defenses Adhesion to vascular beds = Attachment of tumor cells to blood vessel linings</p> Signup and view all the answers

    Match the following factors related to tumor cell spread with their impact:

    <p>Circulation vulnerabilities = Increased susceptibility to immune attack Immune cell suppression = Reduction in tumor cell destruction Primary site growth = Potential lack of critical stromal support Host lymphoid cell interaction = Influence on tumor cell proliferation</p> Signup and view all the answers

    Match the following types of tumors with their characteristics:

    <p>Small cancers = Difficult entry into circulation Tumor cells in circulation = Vulnerable to immune system Large primary tumors = Possibly well-supported by stroma Cancers with intravasation = May face difficulties in tissue invasion</p> Signup and view all the answers

    Match the following concepts related to tumor cells with their correct explanations:

    <p>Metastatic potential = Ability to invade distant tissues Microenvironment influence = Impact of surrounding cells on tumor growth Adhesion mechanisms = Methods by which tumor cells attach to vessels Host immune interactions = Effects of immune responses on tumor development</p> Signup and view all the answers

    Match the following challenges faced by tumor cells with their outcomes:

    <p>Immune system attacks = Increased risk of destruction Limited access to vessels = Reduced chances of spreading Tumor cell adhesion failures = Potential to decrease metastasis Circulatory system dynamics = Influence on tumor cell survival</p> Signup and view all the answers

    Match the following tumor cell characteristics with their implications:

    <p>Lack of stromal support = May hinder primary site growth Intravasation complexity = Challenges in interstitial invasion Circulating tumor cells = Easily targeted by the immune system Resilience in circulation = Ability to evade host immune responses</p> Signup and view all the answers

    Match the following phenomena related to tumor expansion with their effects:

    <p>Difficult tumor cell adhesion = May prevent successful metastasis Vascular interaction weaknesses = Expose cancerous cells to immune attacks Local immune suppression = Enhances tumor cell proliferation Secondary site colonization = Expansion potential in distant tissues</p> Signup and view all the answers

    Match the following cellular interactions with their consequences on tumor proliferation:

    <p>Tumor and immune cell conflict = Possibility of tumor elimination Stromal support presence = Facilitates tumor growth Vascular adhesion success = Contributes to metastasis Lymphoid engagement = Regulates tumor cell dynamics</p> Signup and view all the answers

    Match the following terms with their descriptions related to tumor angiogenesis:

    <p>Caspase 3 = A protein that induces apoptosis p53 = A tumor suppressor that represses VEGF expression VEGF = A factor that promotes blood vessel growth Endothelial cells = Cells that line blood vessels and respond to growth signals</p> Signup and view all the answers

    Match the following pathways with their roles in apoptosis and angiogenesis:

    <p>Intrinsic pathway = Mediates apoptosis through mitochondrial signals Angiogenic signaling = Facilitates the growth of new blood vessels Apoptosis = Programmed cell death Tumor microenvironment = A permissive setting for tumor growth</p> Signup and view all the answers

    Match the following effects with their corresponding mechanisms in tumor biology:

    <p>Loss of p53 = Leads to increased angiogenesis Mutations in apoptosis genes = Contributes to tumor cell resistance Tumor suppressors = Help regulate cell proliferation Pro-angiogenic factors = Stimulate vascular growth towards tumors</p> Signup and view all the answers

    Match the following conditions with their effects on tumor growth:

    <p>Caspase activation = Increases apoptotic cell death VEGF overexpression = Enhances blood vessel formation p53 mutations = Diminishes anti-angiogenic signaling Endothelial dysfunction = Promotes tumor progression</p> Signup and view all the answers

    Match the following substances with their effects on angiogenesis and apoptosis:

    <p>Cytokines = Promote angiogenesis and inflammation VEGF = Stimulates endothelial cell migration and growth Apoptotic factors = Cause programmed cell death in tumor cells Oncogenes = Drive tumor growth and progression</p> Signup and view all the answers

    Match the following roles with the corresponding molecules involved in tumor processes:

    <p>p53 = Regulates the expression of anti-angiogenic factors Caspases = Key executors of the apoptosis process VEGF = Encourages blood vessels to grow towards tumors Endothelial cells = Respond to angiogenic signals in the tumor environment</p> Signup and view all the answers

    Match the following tumor-related phenomena with their implications:

    <p>Apoptosis evasion = Leads to tumor cell survival Angiogenesis = Facilitates nutrient supply to tumors p53 suppression = Favors tumor progression Tumor microenvironment modification = Affects cell signaling and behavior</p> Signup and view all the answers

    Match the following factors with their contributions to tumor angiogenesis:

    <p>VEGF = Primarily triggers new blood vessel formation Caspase 3 = Associated with promoting cell death in the tumor p53 = Inhibits angiogenic signaling pathways Endothelial cells = Form the structural basis of blood vessels</p> Signup and view all the answers

    Match the following cancer treatment strategies with their primary action:

    <p>Checkpoint inhibitors = Avoiding immune destruction BCL2 inhibitors = Inducing cell death MDM2 inhibitors = Reactivate p53 PARP inhibitors = Inducing genome instability</p> Signup and view all the answers

    Match the following tumor characteristics with their description:

    <p>Tumor-promoting inflammation = Activating invasion and metastasis Deregulated cellular energetics = Sustaining proliferative signaling Immortality = Enabling replicative immortality EGFR inhibitors = Deregulating growth signaling</p> Signup and view all the answers

    Match the following types of inhibitors with their target:

    <p>Anti-CTLA-4 = Immune checkpoint Anti-PD-1/PD-L1 = Programmed cell death VEGF inhibitors = Angiogenesis EGFR inhibitors = Epidermal growth factor receptor</p> Signup and view all the answers

    Match the following immune evasion strategies with their description:

    <p>Avoiding immune destruction = Activating immune checkpoints Evading growth suppressors = Deregulating cell cycle control Sustaining proliferative signaling = Continuous growth signals Resisting cell death = Survival despite stress signals</p> Signup and view all the answers

    Match the following signaling pathways with their roles in cancer:

    <p>VEGF signaling = Inducing angiogenesis EGFR signaling = Promoting cell proliferation MDM2 pathway = Regulating p53 activity BCL2 pathway = Inhibiting apoptosis</p> Signup and view all the answers

    Match the following cancer hallmarks with their meanings:

    <p>Activating invasion and metastasis = Spread of cancer cells Sustaining proliferative signaling = Continuous division of cancer cells Resisting cell death = Surviving despite damaging conditions Inducing angiogenesis = Formation of new blood vessels</p> Signup and view all the answers

    Match the following tumor suppressor roles with their functions:

    <p>p53 = Regulating cell cycle and apoptosis BRCA1 = DNA repair mechanisms BRCA2 = Maintaining genome stability MDM2 = Negative regulation of p53</p> Signup and view all the answers

    Match the following forms of cancer therapy with their targets:

    <p>PARP inhibitors = DNA repair processes BCL2 inhibitors = Anti-apoptotic signals EGFR inhibitors = Epidermal growth factor pathway VEGF inhibitors = Tumor vasculature</p> Signup and view all the answers

    Match the following cancer-related processes with their impacts:

    <p>Genome instability and mutation = Increased genomic alterations Angiogenesis = Enhanced nutrient supply Immortalization = Unlimited cell division Inflammation = Promoting tumor progression</p> Signup and view all the answers

    Match the following immune checkpoint inhibitors with their mechanism of action:

    <p>CTLA-4 inhibitors = Blockade of the CTLA-4 surface molecule allowing T cell activation PD-1 inhibitors = Blockade of PD-1 receptor or ligand leading to CTL activation B7 family co-receptors = Facilitate T cell engagement through blockade of inhibitory signals Inhibitory antibodies = Prevent the action of checkpoint inhibitors leading to enhanced immune response</p> Signup and view all the answers

    Match the following tumors with their characteristic immune evasion mechanisms:

    <p>Melanoma = Regresses with CTLA-4 blockade Lung cancer = Sensitive to PD-1 / PD-L1 inhibition Bladder cancer = May express high levels of PD-L1 Hodgkin lymphoma = Often shows enhanced sensitivity to immune checkpoint therapy</p> Signup and view all the answers

    Match the following checkpoint blockade effects with their consequences:

    <p>Blockade of CTLA-4 = Increased activation of CD8+ T cells Blockade of PD-1 = Enhanced cytotoxic activity of CTLs B7 family blockade = Facilitation of T cell activation despite inhibitory signals Inhibitory receptor engagement = Prevention of T cell overactivation and protection from autoimmunity</p> Signup and view all the answers

    Match the following tumor types with their association to immune checkpoint inhibitors:

    <p>Melanoma = Responsive to anti-CTLA-4 therapy Non-small cell lung cancer = Targeted by anti-PD-1 therapy Hodgkin lymphoma = Effective response to PD-1 blockade Bladder cancer = Sensitive to checkpoint inhibition strategies</p> Signup and view all the answers

    Match the following immune modulation strategies with their purposes:

    <p>CTLA-4 blockade = Enhance T cell response against tumors PD-1 pathway inhibition = Reduce inhibitory signals from tumor cells B7 co-stimulation = Promote T cell activation via checkpoint failure Targeting inhibitory antibodies = Increase anti-tumor immunity</p> Signup and view all the answers

    Match the following immune regulatory mechanisms with their roles:

    <p>PD-1 signaling = Inhibitory signal leading to T cell exhaustion CTLA-4 activity = Downregulates T cell activation and promotes tolerance B7 family interactions = Provide necessary co-stimulation for T cell activation Tumor microenvironment factors = Create suppressive conditions for immune cells</p> Signup and view all the answers

    Match the following terms related to immune response in tumors with their definitions:

    <p>Cytotoxic T cells (CTLs) = Effector T cells that kill cancer cells Checkpoint inhibitors = Therapeutics that block inhibitory signals in T cells Immune evasion = Mechanisms by which tumors avoid detection and destruction Co-stimulatory signals = Signals that enhance T cell activation alongside antigen recognition</p> Signup and view all the answers

    Match the following immune reactions with their targets in cancer therapy:

    <p>CTLA-4 blockade = Direct activation of cytotoxic CD8+ T cells PD-1 inhibition = Reversal of T cell inhibition in tumor environments B7 interaction manipulation = Strengthening of T cell engagement to tumors Inhibitory antibody application = Reduction of T cell dysfunction and enhancement of immunity</p> Signup and view all the answers

    Match the following effects of tumors with their descriptions:

    <p>Clinical Effects = Causes local and systemic problems in the body Anaomc ocaon = Determines the location of the tumor Space-- occupation = Effects of benign and malignant tumors Paraneoplastic recognition = Recognition of cancer patients</p> Signup and view all the answers

    Match the following terms with their descriptions:

    <p>Hallmarks of cancer = Characteristics of cancer cells Neoplasms = Abnormal growth of cells Benign tumors = Non-cancerous tumors Malignant tumors = Cancerous tumors</p> Signup and view all the answers

    Match the following processes with their effects on tumor cells:

    <p>Intravasation = Tumor cells enter the bloodstream or lymphatic vessels Extravasation = Tumor cells exit the bloodstream or lymphatic vessels Adhesion = Tumor cells stick to the endothelial lining of blood vessels Motility = Tumor cells move to a new location</p> Signup and view all the answers

    Match the following factors with their effects on tumor growth:

    <p>Hormones = Can stimulate or inhibit tumor growth Immune cells = Can recognize and destroy tumor cells Stromal support = Provides a supportive environment for tumor growth Paracrine effectors = Can promote or inhibit tumor growth</p> Signup and view all the answers

    Match the following concepts with their descriptions:

    <p>Tumor-Promoting Inflammation = Inflammation that promotes tumor growth DNA mismatch repair = Process that corrects DNA errors BRCA1 and BRCA2 = Tumor suppressor genes MDM2 inhibitors = Drugs that inhibit MDM2 protein</p> Signup and view all the answers

    Match the following therapeutic targets with their effects:

    <p>VEGF inhibitors = Inhibit angiogenesis PARP inhibitors = Inhibit DNA repair BCL2 inhibitors = Induce apoptosis Checkpoint inhibitors = Enhance immune response</p> Signup and view all the answers

    Match the following concepts with their effects on cancer development:

    <p>Somatic mutations = Can lead to cancer Germ line mutations = Can increase cancer risk DNA repair genes = Protect against cancer Tumor suppressor genes = Inhibit cancer growth</p> Signup and view all the answers

    Match the following clinical implications with their descriptions:

    <p>Grading tumors = Evaluates tumor aggressiveness Staging tumors = Evaluates tumor extent Cytokine action = Influences immune response Free fatty acids = Can promote tumor growth</p> Signup and view all the answers

    Study Notes

    Tumor Biology and Metastasis

    • Cleavage products of the extracellular matrix components, such as collagen and laminin, and certain growth factors contribute to tumor cell behavior.
    • Tumor and stroma cells produce proteases that facilitate the invasive potential of cells through the basement membrane.

    Vascular Dissemination and Tumor Cell Homing

    • Tumor cells frequently evade local sites of origin to infiltrate blood circulation or lymphatics, leading to systemic spread.
    • Intravasation refers to the process where tumor cells enter the bloodstream or lymphatic system, driven by various factors, which can occur even in small cancers.
    • Circulating tumor cells are susceptible to destruction by immune cells during their journey through the bloodstream.

    Interaction with Host Cells

    • Tumor cells may grow poorly in foreign environments lacking critical support or may be inhibited by local immune cells.
    • Genetic mutations, such as those in BRCA1 and BRCA2, heighten the risk of cancers including breast cancer due to compromised DNA repair mechanisms.

    Tumor-Promoting Inflammation

    • Chronic inflammation is identified as a key factor in the development of various cancers, including hereditary nonpolyposis colorectal cancer (HNPCC).
    • DNA repair mechanisms are crucial for reversing DNA damage that can lead to tumor development.

    Mechanisms of Tumorigenesis

    • Checkpoint inhibitors, including anti-CTLA-4 and anti-PD-1/PD-L1, are pivotal in combating immune evasion by tumors.
    • Growth suppressors and genes promoting cellular energetics play roles in sustaining tumor growth and signaling.
    • Enabling metastatic traits involves inducing angiogenesis and resisting cell death through altered cellular responses.

    Cancer Genetics and Mechanisms

    • Tumor suppressor genes, including both copies of BRCA1 and BRCA2, must be inactivated for cancer to develop, implicating their importance in cell cycle regulation and DNA repair.
    • Somatic mutations accumulate over time, contributing to the progression of various cancers, including carcinomas and lymphomas.

    Paraneoplastic Syndromes

    • Paraneoplastic syndromes emerge as complex symptom complexes that cannot be attributed merely to local tumor effects but indicate broader systemic impacts.

    Prognostic Factors in Cancer

    • Tumor stage, characterized by the extent of spread and aggressiveness, serves a critical role in determining patient prognosis and treatment strategies.
    • Histopathological grading is essential for assessing cancer severity and guiding therapeutic interventions.
    • BAX/BAK activation is stimulated by proangiogenic factors released by tumor cells and inflammatory cells such as macrophages and stromal fibroblasts.
    • Key anti-apoptotic proteins involved in tumor survival include BCL-2, BCL-XL, and MCL-1, often associated with the mitochondria.
    • Tumor cells can release peptides that enhance angiogenic activity from surrounding stromal cells.

    Tumor Cell Intravasation and Circulation

    • Intravasation refers to tumor cells entering the bloodstream, occurring even from small cancers.
    • Various factors can affect the metastatic potential of circulating tumor cells, including their vulnerability to destruction by immune cells.
    • Adhesion to vascular beds and subsequent invasion of normal tissues is more complex for tumor cells than for normal cells.

    Host Interaction and Immune Evasion

    • Tumor cells grow well in the primary site but may lack crucial stromal support or be suppressed by resident immune cells.
    • The expression of tissue-specific adhesion molecules and the production of specific chemokines by tumor cells play essential roles in extravasation and metastasis.
    • Metastatic cells can create favorable or unfavorable microenvironments for tumor growth in new tissues.

    Immune System Dynamics

    • The immune system can recognize and destroy tumors, but some cancers evolve to evade or inhibit these immune responses.
    • CD8+ T cells are significant predictors of outcomes in initiating nascent cancers, indicating a strong immune response.
    • Cancer survival is linked to the ability of tumor cells to evade the host immune system or actively suppress it, known as the immunoscore.

    Implications for Cancer Therapy

    • Understanding tumor-immune interactions has led to advancements in immunotherapy, although the efficacy of different immune mechanisms remains an open question.
    • A deeper comprehension of the behaviors of individual cancers in relation to the immune environment is crucial for developing effective treatments.

    Extravasation and Metastasis

    • Tumor cells express tissue-specific adhesion molecules for extravasation, allowing them to migrate from blood vessels into tissues.
    • The production of specific chemokines in diverse tissues facilitates the homing of metastatic cancer cells, which express corresponding receptors.
    • The presence of stroma can further support the growth of metastatic tumors by modifying the tissue environment.

    Immune Checkpoints and Cancer

    • Immune checkpoints such as PD-1 and CTLA-4 play crucial roles in regulating T cell activation.
    • Blocking PD-1 or CTLA-4 with antibodies inhibits these checkpoints, potentially enhancing anti-tumor immunity.
    • Dendritic cells present tumor peptides through MHC molecules, which is vital for T cell priming and activation.

    DNA Repair and Cancer Risk

    • Defective DNA repair mechanisms, particularly homologous recombination, are linked to oncogenic processes.
    • Germline mutations in BRCA1 and BRCA2 genes significantly increase the risk of breast and ovarian cancers, with these mutations found in approximately 50% of familial breast cancers.

    Cancer Treatment Mechanisms

    • Checkpoint inhibitors (anti-CTLA-4, anti-PD-1/PD-L1) aim to avoid immune destruction of tumors.
    • Treatments targeting EGFR and BCL2 contribute to sustaining proliferative signaling and resisting apoptosis in cancer cells.
    • VEGF signaling inhibitors can disrupt angiogenesis, essential for tumor growth.

    Paraneoplastic Syndromes

    • Endocrinopathies, including Cushing syndrome and hypercalcemia, are associated with various cancers, indicating a complex relationship between tumors and hormone regulation.
    • Symptoms such as inappropriate ADH secretion (SIADH) and hypercalcemia may arise from tumor-derived substances that mimic hormone actions.
    • Neurological disorders like myasthenia and dermatological conditions such as dermatomyositis can also be manifestations of underlying malignancies.

    Hematological and Vascular Changes

    • Tumors can induce hypercoagulability, leading to conditions like venous thrombosis, particularly noticeable in pancreatic cancer and other malignancies.
    • Red cell aplasia and polycythemia can occur due to immunologic responses related to tumors, emphasizing the multifaceted nature of cancer effects on the body.

    Angiogenesis and Tumor Progression

    • Angiogenesis refers to the formation of new blood vessels, critical for tumor growth and metastasis.
    • Normal human cells can double 60 to 70 times before senescence occurs, influenced by the availability of blood vessels.
    • Senescence is associated with telomere shortening on chromosomes, impacting the ability of cells to divide.
    • Loss of E-cadherin in many patients correlates to increased cell migration and aggressiveness of cancer.

    Immune Responses and Cancer

    • Tumors can vary immune responses, leading to changes in cell shape and mutations, worsening patient outcomes.
    • Certain cancers often exhibit upregulation of genes associated with mesenchymal characteristics, promoting invasive behaviors.
    • Immunologic changes in tumor environments are often referred to as epithelial-to-mesenchymal transition (EMT).

    Therapeutic Targets

    • Recent therapeutic agents stimulate T-cell responses and can enhance immune effectiveness.
    • Drugs targeting PD-1 and CTLA-4 have been developed to inhibit cancer cells from evading immune detection.

    Local Effects of Tumors

    • Tumors can cause both local and systemic problems due to direct impact on surrounding tissues and production of hormones.
    • Recognition of tumor anatomy is critical as it determines treatment approaches and potential surgical interventions.
    • Benign and malignant tumors can create "space-occupying" effects, impacting normal organ function.

    Genetic Mutations in Cancer

    • Hereditary Non-Polyposis Colorectal Cancer (HNPCC) accounts for only 2% to 4% of colorectal cancers but is significant for its genetic implications.
    • Microsatellite instability (MSI) can be observed in approximately 15% of sporadic cancers, indicating mutations that can lead to various cancer types.
    • Recent advancements focus on targeting cancer hallmarks through approved therapies and ongoing clinical trials, enhancing overall survival rates.

    Angiogenesis and Tumor Growth

    • Angiogenesis is stimulated by factors like Caspase 3, which promotes the proliferation of endothelial cells and guides new blood vessel formation towards tumors.
    • Tumor suppressors can balance processes to favor angiogenesis; for instance, p53 inhibits VEGF expression, preventing angiogenic stimulation.
    • Loss of p53 in tumor cells creates an environment conducive to angiogenesis by allowing tumor cells to evade apoptosis.

    Tumor Cell Intravasation

    • Intravasation refers to the process by which tumor cells enter the bloodstream, which is facilitated by several factors that influence their metabolic potential.
    • Tumor cells are vulnerable to destruction by immune cells during circulation, complicating their ability to adhere to vascular beds and invade normal tissues.
    • The link between primary tumor growth and immune response is critical; resident immune cells can suppress tumor growth.

    Tumor Immunity and Checkpoint Inhibitors

    • Checkpoint inhibitors, such as anti-CTLA-4 and anti-PD-1/PD-L1, enhance T cell activation by blocking inhibitory signals, allowing CD8+ T cells to attack tumors.
    • Tumor evasion strategies include avoiding immune destruction and reactivating growth suppressors like p53, using inhibitors that target pathways like MDM2.

    Hallmarks of Cancer and Therapeutic Targets

    • Major therapeutic approaches aim to counteract cancer hallmarks by targeting key cancer-related signaling pathways, such as EGFR and VEGF.
    • Inhibitors of cellular proliferative signaling and apoptosis (e.g., BCL2 inhibitors) are being developed to disrupt cancer growth and metastasis.

    Clinical Effects of Tumors

    • Both benign and malignant tumors can cause local and systemic problems, affecting physiological processes through direct interaction and hormone elaboration.
    • Recognition of the anatomical location of tumors is critical, as it determines the potential for complications and influences treatment strategies.

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    This quiz covers the role of extracellular matrix components and growth factors in tumor cell behavior, as well as vascular dissemination and tumor cell homing. It explores how tumor cells invade the basement membrane and evade local sites of origin to spread systemically.

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