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Biology of Cancer SSC > Cancer Biomarkers > Flashcards

Cancer Biomarkers Flashcards

1
Q

What is a cancer biomarker?

A

A substance or process that is indicative of the presence of cancer in the body

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2
Q

What 3 primary ways are biomarkers used in cancer research and medicine?

A
  • Prognostic
  • Diagnostic
  • Predictive (response to treatment)
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3
Q

What other uses do cancer biomarkers have?

A
  • Monitoring a condition

- Risk/screening

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4
Q

What 4 categories of biomolecules can be used as biomarkers?

A
  • Genetic
  • Epigenetic
  • Proteomic
  • Glycomic
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5
Q

What genetic biomolecules can be used as biomarkers?

A
  • DNA mutations/CNA (circulating nucleic acids)

- mRNA expression

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6
Q

What epigenetic biomolecules can be used as biomarkers?

A
  • DNA methylation
  • Histone methylation
  • miRNA gene silencing
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7
Q

What proteomic biomolecules can be used as biomarkers?

A
  • Protein levels

- Post translational modifications

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8
Q

What glycomic biomolecule can be used as biomarkers?

A

-Glucose metabolism

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9
Q

What is genomics?

A

Mutation and gene expression profiling

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10
Q

What is transcriptomics?

A

All RNA transcripts

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11
Q

What is proteomics?

A

Proteome profiling of biological fluids

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12
Q

What is metabolomics?

A

Metabolic fingerprinting in biological systems

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13
Q

What is lipidomics?

A

Complete lipid profile within a cell, tissue or organism

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14
Q

What is epigenetics?

A

Modification of nuclear DNA

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15
Q

What can be looked for in the blood?

A
  • Circulating tumour cells (CTCs)
  • DNA/RNA
  • miRNA
  • PSA
  • Exosomes
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16
Q

What can be looked for in tissues?

A
  • DNA/RNA
  • AMACR
  • Histopathology/IHC
  • Gleason score
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17
Q

What can be looked for in urine?

A
  • DNA/RNA
  • miRNA
  • Prostasomes/Exosomes
  • PCA3
  • TMPRSS2:ERG
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18
Q

What are AMACR, TMPRSS2:ERG and PCA3?

A

Prostate cancer markers

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19
Q

What can be looked for in semen?

A
  • Prostasomes
  • Exosomes
  • Proetins
  • DNA/RNA
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20
Q

What are the advantages of blood/plasma biomarkers?

A

The procedure is minimally invasive and low cost

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21
Q

What are the disadvantages of blood/plasma biomarkers?

A

Complex, and wide patient variability

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22
Q

What are the advantages of tissue biomarkers?

A

Diagnostic and prognostic, and can analyse markers directly from tissue

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23
Q

What are the disadvantages of tissue biomarkers?

A

Highly invasive, high cost, and associated side effects due to method of acquiring sample

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24
Q

What are the advantages of urine biomarkers?

A

Non invasive, large volume, low cost, get access to proteins directly from prostate

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25
Q

What are the disadvantages of urine biomarkers?

A

Low concentration of molecules, high variability between patients

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26
Q

What are the advantages of semen biomarkers?

A

relatively non invasive, large volume, low cost, access to proteins directly from prostate

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27
Q

What are the disadvantages of semen biomarkers?

A

Low concentration of molecules, high variability between patients

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28
Q

What 7 things should the ideal biomarker be?

A
  • Specific
  • Sensitive
  • Predictive
  • Robust
  • Reflective of kinetics
  • Minimally-invasive to obtain
  • Have (pre-)clinical importance
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29
Q

What should a biomarker be specific to?

A

Disease type and stage

30
Q

What should a biomarker be sensitive to?

A

Single molecules - detections at earliest stage for optimised treatment

31
Q

What should a biomarker be predictive of?

A
  • Stratification
  • Treatment response
  • Recurrence
32
Q

How should a biomarker be robust?

A

Fast, simple and cheap to test for

33
Q

What kinetics should a biomarker reflect?

A

Pathological processes and therapy response

34
Q

What are genetic biomarkers of risk?

A

Method for determining predisposition and risk of developing cancer.

35
Q

What is the genetic biomarker of risk for breast cancer and ovarian cancer?

A

BRCA1/2

36
Q

What is a genetic biomarker of cancer risk that works for brain cancer, cervical cancer and oral cancer?

A

Abnormal methylation/hypermethylation of specific genes

37
Q

What mutations are genetic biomarkers of risk for GI cancers?

A

EGFR, KRAS, TP53 and ERBB2

38
Q

What qualities must biomarkers for cancer SCREENING have?

A
  • Highly specific to minimise false positives and negatives
  • Detetable with minimal complication/cost
  • Released into serum or urine for minimal invasiveness
  • Clearly reflect the different early stages of disease
39
Q

What is PSA produced by?

A

Epithelial cells of the prostate

40
Q

How is PSA present in healthy males?

A

At small quantities

41
Q

How does this change in males with prostate cancer?

A

Elevated in some patients

42
Q

What levels of PSA are considered suspicious and require biopsy?

A

4-10ng/ml

43
Q

Is PSA level specific enough?

A

Not considered to be in UK so not part of screening programme for prostate cancer (UK doesn’t have one)

44
Q

What is PSA used with in risk stratification of prostate cancer?

A

Grade (Gleason grading) and Stage (imaging)

45
Q

What is the low risk score for prostate cancer risk stratification?

A

Psa <10, Gleason score ≤6, and Clinical stage ≤T2a

46
Q

What is the intermediate risk score for prostate cancer risk stratification?

A

PSA 10-20, Gleason score 7, or clinical stage T2b/c

47
Q

What is the high risk score for prostate cancer risk stratification?

A

PSA >20, Gleason score ≥8, or clinical stage ≥T3

48
Q

How are cervical cells collected?

A

Pap smear

49
Q

Who is the cervical screening programme available to?

A

Women aged 25 to 64

50
Q

How often are women invited to be screened for cervical cancer?

A

25-49 every 3 years, 50-64 every 5 years

51
Q

What is the diagnostic biomarker for liver cancer?

A

Alpha-foetoprotein

52
Q

What is the diagnostic biomarker for ovarian cancer?

A

Cancer antigen 125 (aka MUC16) - not foolproof

53
Q

What is the diagnostic biomarker for breast cancer in metastatic disease?

A

CA15-3

54
Q

What is the diagnostic biomarker for colorectal cancer?

A

CA19-9

55
Q

What is the diagnostic biomarker for pancreatic cancer?

A

CEA (Carcinoembryonic Antigen)

56
Q

What is the diagnostic biomarker for prostate cancer?

A

PSA

57
Q

What is the diagnostic biomarker for chronic myeloid leukaemia?

A

BCR-ABL - very commonly used as 95% of CML patients have it

58
Q

What is BCR-ABL in CML targetted by?

A

Imatinib

59
Q

What is a prognostic biomarker?

A

Biomarker that indicates the likely course of disease in an untreated individual

60
Q

What is a predictive biomarker?

A

Biomarker that identifies subgroups of patients who are most likely to respond to a given therapy

61
Q

What is a predictive biomarker in highly aggressive breast cancers?

A

ERBB2 amplification

62
Q

What is ERBB2 amplification positive breast cancer targetted by?

A

Trastuzumab (herceptin)

63
Q

Why are circulating biomarkers so important?

A

Tumours vary person to person, but the tumour within one patient can also be different to itself - Heterogeneity.

64
Q

What is cell-free DNA?

A

DNA circulating in plasma, derived by apoptosis/necrosis/active secretion.

65
Q

When is cell-free DNA elevated?

A

In tumour cell turnover

66
Q

What can cfDNA be used as an early diagnostic marker in?

A

Breast cancer detection - analyse in patients with suspicious mammogram.

67
Q

What are CTCs?

A

Circulating tumour cells - tumour cells that have been shed into the bloodstream

68
Q

What are CTCs useful for?

A

Prognosis and prediction, as well as being very useful in monitoring.

69
Q

How many CTCs is bad?

A

> 5 CTCs in one sample = very bad prognosis

70
Q

What are the problems with CTCs?

A

They are very rare (1:1,000,000) and difficult to isolate

71
Q

Where are circulating miRNAs used?

A

In the USA as a biomarker. Not the UK as too variable.

Biology of Cancer SSC (16 decks)

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