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Biology of Cancer SSC > Cancer Biomarkers > Flashcards

Cancer Biomarkers Flashcards

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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
What are the disadvantages of urine biomarkers?
Low concentration of molecules, high variability between patients
26
What are the advantages of semen biomarkers?
relatively non invasive, large volume, low cost, access to proteins directly from prostate
27
What are the disadvantages of semen biomarkers?
Low concentration of molecules, high variability between patients
28
What 7 things should the ideal biomarker be?
- Specific - Sensitive - Predictive - Robust - Reflective of kinetics - Minimally-invasive to obtain - Have (pre-)clinical importance
29
What should a biomarker be specific to?
Disease type and stage
30
What should a biomarker be sensitive to?
Single molecules - detections at earliest stage for optimised treatment
31
What should a biomarker be predictive of?
- Stratification - Treatment response - Recurrence
32
How should a biomarker be robust?
Fast, simple and cheap to test for
33
What kinetics should a biomarker reflect?
Pathological processes and therapy response
34
What are genetic biomarkers of risk?
Method for determining predisposition and risk of developing cancer.
35
What is the genetic biomarker of risk for breast cancer and ovarian cancer?
BRCA1/2
36
What is a genetic biomarker of cancer risk that works for brain cancer, cervical cancer and oral cancer?
Abnormal methylation/hypermethylation of specific genes
37
What mutations are genetic biomarkers of risk for GI cancers?
EGFR, KRAS, TP53 and ERBB2
38
What qualities must biomarkers for cancer SCREENING have?
- 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
What is PSA produced by?
Epithelial cells of the prostate
40
How is PSA present in healthy males?
At small quantities
41
How does this change in males with prostate cancer?
Elevated in some patients
42
What levels of PSA are considered suspicious and require biopsy?
4-10ng/ml
43
Is PSA level specific enough?
Not considered to be in UK so not part of screening programme for prostate cancer (UK doesn't have one)
44
What is PSA used with in risk stratification of prostate cancer?
Grade (Gleason grading) and Stage (imaging)
45
What is the low risk score for prostate cancer risk stratification?
Psa <10, Gleason score ≤6, and Clinical stage ≤T2a
46
What is the intermediate risk score for prostate cancer risk stratification?
PSA 10-20, Gleason score 7, or clinical stage T2b/c
47
What is the high risk score for prostate cancer risk stratification?
PSA >20, Gleason score ≥8, or clinical stage ≥T3
48
How are cervical cells collected?
Pap smear
49
Who is the cervical screening programme available to?
Women aged 25 to 64
50
How often are women invited to be screened for cervical cancer?
25-49 every 3 years, 50-64 every 5 years
51
What is the diagnostic biomarker for liver cancer?
Alpha-foetoprotein
52
What is the diagnostic biomarker for ovarian cancer?
Cancer antigen 125 (aka MUC16) - not foolproof
53
What is the diagnostic biomarker for breast cancer in metastatic disease?
CA15-3
54
What is the diagnostic biomarker for colorectal cancer?
CA19-9
55
What is the diagnostic biomarker for pancreatic cancer?
CEA (Carcinoembryonic Antigen)
56
What is the diagnostic biomarker for prostate cancer?
PSA
57
What is the diagnostic biomarker for chronic myeloid leukaemia?
BCR-ABL - very commonly used as 95% of CML patients have it
58
What is BCR-ABL in CML targetted by?
Imatinib
59
What is a prognostic biomarker?
Biomarker that indicates the likely course of disease in an untreated individual
60
What is a predictive biomarker?
Biomarker that identifies subgroups of patients who are most likely to respond to a given therapy
61
What is a predictive biomarker in highly aggressive breast cancers?
ERBB2 amplification
62
What is ERBB2 amplification positive breast cancer targetted by?
Trastuzumab (herceptin)
63
Why are circulating biomarkers so important?
Tumours vary person to person, but the tumour within one patient can also be different to itself - Heterogeneity.
64
What is cell-free DNA?
DNA circulating in plasma, derived by apoptosis/necrosis/active secretion.
65
When is cell-free DNA elevated?
In tumour cell turnover
66
What can cfDNA be used as an early diagnostic marker in?
Breast cancer detection - analyse in patients with suspicious mammogram.
67
What are CTCs?
Circulating tumour cells - tumour cells that have been shed into the bloodstream
68
What are CTCs useful for?
Prognosis and prediction, as well as being very useful in monitoring.
69
How many CTCs is bad?
>5 CTCs in one sample = very bad prognosis
70
What are the problems with CTCs?
They are very rare (1:1,000,000) and difficult to isolate
71
Where are circulating miRNAs used?
In the USA as a biomarker. Not the UK as too variable.

Biology of Cancer SSC (16 decks)

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