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1st lecture Flashcards

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1
Q

normal cell prohibited from growing by ?

A

adjacent cells touching

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2
Q

tumor suppressors are?

A

susceptibility genes that survey the cell and prevents the cell from acquiring mutations

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3
Q

someone went to the doctor and they felt lump on their tongue and it wasnt there. last week. where did it come from?

A

it was there a long time and continued to get mutations because it takes a long time to accumulate mutations and getting the cancer

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4
Q

lead time bias

A

a flaw of many screening trials

catching cancers that are not going to kill people

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5
Q

lead time is

A

length of time btw detection of a disease and its clinical presentation and diagnosis

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6
Q

lead time bias is

A

the bias that occurs when 2 tests for disease are compared and one test diagnoses the disease earlier but no effect on outcome of the disease

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7
Q

telemerase

A

repeats of sequences where one sequence gets clipped off each time a cell divides

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8
Q

steps to turn. to a cancer

A

telemers are prolonged and keep divding forever not becoming scenescense by the hTERT gene

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9
Q

steps to turn. to a cancer

A

telemers are prolonged and keep divding forever not becoming scenescense by the hTERT gene
stops adhesion
inhibits apoptosis
invades

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10
Q

senescence cells

A

are flat cells that cannot replicate bc cannot put telomere at end of chromosome to replicate

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11
Q

carcinoma insitu

A

cancer fills the duct but cannot get out of duct

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12
Q

invasive cancer

A

when cancer learned how to make hole in basement membrane and go through

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13
Q

invasive phenotype is key to

A

metastasis and is what kills people

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14
Q

matrix metalloproteinases (MMPs)

A

are secreted by tumor and stromal cells
degrades extracellular matrix.
this degradation is key for metastatic and angiogenic processes

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15
Q

cell migration

A
  1. extension
  2. adhesion
  3. formaiton of actin filament
  4. traction
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16
Q

can you cure metastatic disease?

A

no it is a chronic disease so you live with your cancer

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17
Q

cancer stem cells stays if you give it ?

A

chemotherapy

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18
Q

cancer cells get into 100% serum and they live even though serum is

A

very toxic

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19
Q

the best place for a cancer to live is ?

A

where it was born because they live in a microenvironment where there is lots of support and nutrition

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20
Q

colonization

A

when cancer cell travels to another organ

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21
Q

angiogenesis

A

gives a cancer blood supply and is induced by hypoxia angiogenic factors FGF2 and VEGF. vascular cells grow into tumor

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22
Q

low vascular count =

A

live forever and makes difference in tumors

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23
Q

micrometastis

A

these cells travel to far places before you know you have cancer
makes you live less

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24
Q

patients with bone marrow micrometastases at diagnosis have

A

worse survival

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25
frequency of cytokerative positive cells in bone marrow is ?
unaffected by chemotherapy
26
frequency of cytokerative positive cells in bone marrow is ?
unaffected by chemotherapy
27
adjuvant chemotherapy
used against micrometastases
28
cancer cells are not attacked by T cells because?
cancer cells have protein called PDL-1 that sends don't eat me signal by blocking PD 1 (programmed death) receptor
29
10^12 (1kg)
death
30
10^9 (10g)
tumor causes first symptoms and is measurable and detectable
31
10 divisions you get
1000 cells
32
need 1 cubic cm tumor to?
see on xray
33
need 1 cubic cm (1g) tumor to? 30 cell division
see on xray and if anything less than 1 cubic cm then not considered a cancer
34
4 ways of getting chemotherapy
1. induction treatment - no alternative therapy exists and is inoperable or metastic and to help pt live longer. use combo of drugs 2. adjuvant chemo- cut out cancer and give treatment for less chance of cancer coming back. define response as complete, partial, stable or progression 3. primary chemotherapy - to shrink tumor before surgery. and if you shrink it until looks gone, you must still do surgery to be 100% sure 4. special use chemotherapy - highest concentration of drug against target tumor
35
4 ways of getting chemotherapy
1. induction treatment - no alternative therapy exists and is inoperable or metastic 2. adjuvant chemo- cut out cancer and give treatment for less chance of cancer coming. back 3. primary chemotherapy (neoadjuvant) - to shrink tumor before surgery. 4. special use chemotherapy - highest concentration of drug against target tumor
36
chemotherapy works best on ?
cycling cells
37
why give multiple drugs?
to hit different parts of the cancer cell metabolism bc made up of different clones of cancer
38
goldie - coldman hypothesis
give multiple drugs at once or cycle non-crossresistant regimens to interact with the many different clones of cancer cells. each time it divides it acquires more mutations.
39
combination chemotherapy
need combo of drugs for durable response
40
how would you know which drug to use?
if it worked in clinical trial
41
side effects of chemotherapy
``` chemo brain hair falls N/V cardiotoxicity \ ```
42
side effects of chemotherapy
``` chemo brain hair falls N/V cardiotoxicity bone marrow suppression pulmonary toxicity chemical cystitis gonadal dysfunction - arrest of follicular maturation/destruction of ova and follicles ```
43
severe acneiform rash of CI-1040 MEK inhibitor in phase 1 trial means?
that the treatment is working
44
can measure treatment response by ?
biopsying the tumor | measuring lymphocytes in blood
45
antitumor agents associated with ?
Testicular germ cell depletion | ovarian dysfunction
46
alkylating agents caused?
ovarian failure | worse for testicular function too
47
key to licensing?
compliance monitoring
48
classification of chemotherapy cytotoxic agents
alkylating - full cell cycle and hits stem cells and affects dna antimetabolites - work in s phase mitotic inhibitors - m phase anitibiotics - s phase and affects dna
49
chemotherapy works best on
cycling cells
50
what really hurts stem cells?
alkylating agent because works all throughout cycle and will modify dna and cause cell to die.
51
drug resistance
stem cells are drug resistant pump out drugs binding drug to protein that inactivates it
52
combination of chemotherapy accomplishes what 3 objectives?
maximal cell kill within range of tolerated toxicity covers broad range of resistant cell lines prevents or slows down new clone development
53
what drugs can you use to treat cancer?
only those tested in clinical trial that shrank tumor
54
the national research act of 1974 established?
the national comission -dentification of guidelines, ethical principles and regulation
55
aim of combination therapy?
increased efficacy different mechanisms of action different mechanisms of resistance compatible side effects
56
micrometastatic
metastic tumor too small to be identified in scan
57
patients with bone marrow micrometastases at diagnosis have ?
worse survival
58
primary tumor metastasize to?
bone marrow | axillary lymph nodes
59
effects of vascular count and EGFR on survival are?
having low vascular count means you live longer
60
breast cancer progression
1. genetic instability (mutation) 2. loss of polarity 3. loss of proliferative control by adjacent cells (adhesion molecule loss) 4. exit from G0, entry to cell cycle- receptor, oncogene mutations 5. Decreased ability to undergo apoptosis 6. loss of scenscence, telomerase hTERT re-expression 7. acquisition of invasive phenotype - key to metastasis 8. acquisition of angiogenic phenotype, FGF2 VEG
61
name targets for chemotherapy
oncogenes | tumor suppressor genes
62
name cell cycle regulators
oncogenes | tumor supressor genes
63
invasive cancer
made hole through basement membrane and leads to primary cancer to metastasize
64
adverese effect assesment includes?
grade 0-4 was the event anticipiated attribution or associatin to protocol therapy

oncology (7 decks)

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