tumor progression
normal -> hyperplastic –> dysplastic –> neoplastic (cells become immortal) –> metastatic
tumor progression results from waves of mutation followed by
clonal expansion
incidence of cancer increases exponentially with
age (5th to 6th power)
are cancers derived from a single cell
yes they are monoclonal - mutation increases with time
what strongly suggests that cancer cells are derived from a single cell
all cells from cancer have the same copy of the X inactivated
malignancy of B cell (produce antibody producing plasma cells)
multiple myeloma
all myeloma patients produce the same antibody molecule which is
monoclonal Ig (M-spike) proves monoclonality of cancer
net cell growth in a healthy individual is what
cell birth = cell death
in cancer, cell birth > cell death
what are the cancer causing genes
oncogenes (normally stimulates growth) suppressor genes (normally inhibit growth) repair genes (normally limit mutations)
types of mutations in the cancer causing genes
proto-oncogene - gain of function mutation
tumor suppressor genes - loss of function
repair genes - increase frequency of mutations
MAP kinase pathway - cellular growth control
- growth factors
- growth factor receptor tyrosine kinase
- cytoplasmic receptor tyrosine kinase
- proteins with GTPase activity/cytosolic signal transducer
- DNA binding nuclear protein transcription factors
for cellular growth control, where do the instructions come from
outside of the cell (growth factors)
1 and 2 are extracellular
3 and 4 are cytoplasmic
5 on nucleus
regulates cell proliferation
proto-oncogenes <— mutation in it leads to oncogene
what happens when mutation of proto-oncogene
production of mutant protein that results that stimulates cell division or increased expression of a gene that leads to large amount of protein which stimulates cell division
how does MAP kinase cascade amplify signals
through geometric recruitment
what happens with the activation of kinases
phosphorylation of serine and threonine residues
how is tyrosine kinase receptor/growth receptor activated
ligand aka growth factors bind to the receptors which then dimerize and phosphorylate then there is further phosphorylation of tyrosine residues
how do you oncogenically activate a receptor
point mutation on the receptor (Val –>Gln) which changes a single amino acid making receptor constitutively active (Neu oncoprotein)
truncation/deletion - in absence of signal, receptors still dimerize and become constitutively active (ErbB oncoprotein)
oncogenic activation by translation aka illegitimate recombination
Burkitt lymphoma (activation of myc) chronic myeloid leukemia (activation of abl)
what is myc
nuclear transcription factor (5) that is impo for G1/S transition and stimulates the cell cycle
mechanism in Burkitt lymphoma
recombination between chromosome 8 and 14 which puts myc (8) under the control of IgH promoter (14) now causing increased production of myc (usually made in small amounts) which leads to overstimulation of the cell cycle —> cancer
what fails to differentiate in Burkitt lymphoma
lymphocytes
another name for chronic myeloid leukemia
philadelphia chromosome 22
mechanism in chronic myeloid leukemia
recombination between chromosome 9 and 22 which makes a hybrid with abl (9) and bcr (22) genes fused together —> unregulated cystolic tyrosine kinase so abl is stuck in its active form not needing a signal to activate
what is abl
a cytoplasmic tyrosine kinase (3)
what can be used to block the bcr-abl hybrid
gleevec or imatinib mesylate (STI571)
mechanism of imatinib mesylate
it is a tyrosine kinase inhibitor so it binds to the bcr-abl hybrid active site and prevents its activity
A 52 year-old man with chronic myelogenous leukemia tests positive for the presence of the Philadelphia chromosome. How does this change the ABL proto- oncogene to an oncogene? This protein
constitutive kinase activity
what is Ras (4)
GTPase involved in major cell proliferative pathway
how does Ras work
when GDP phosphorylated to GTP and binds to Ras, it is active but once it binds to GDP, it becomes inactive so it needs constant stimulation to grow
how does Ras become constitutively active
when a mutation occurs that inhibits GTPase activity so Ras stays bound to GTP hence there is growth
mutation - single point mutants at Gly12 or Gln61
what is usually seen with FISH probes in tumors where amplified region includes an oncogene
double minutes - extrachromosomal fragments of DNA
Abnormal Homogeneously Staining Regions of Chromosomes in Cancers Often contain
amplified oncogenes
growth factor receptor
HER2
cytosolic signal transducer
Ras
A clinical genomicist observes dmins (double minutes) in a metaphase spread. These aberrations result due to which of the following processes?
extrachromosomal fragments of DNA/ extrachromosomal gene amplifications
A clinical genomicist observes hsrs (homogeneously staining regions) in a metaphase spread. These aberrations result due to which of the following processes
gene amplification in tandem
many inherited disposition to cancer result from mutations in
tumor suppressor genes
loss of function in the WT1 gene on chromosome 11
Wilms Tumor 11
what does the WT1 gene encode
transcription factor needed for cell growth and differentiation
tumor suppressor gene encode for proteins that do what
stop cancer - DNA repair proteins, control cell cycle, promote apoptosis
how many copies of the tumor suppress gene do you need to be mutated to have cancer
both copies need to be mutated - two hit hypothesis
basis for the two hit hypothesis
familial and non familial (sporadic) forms of cancer exist
-mutation occurs in tumor suppressor gene on one homolog in 1st hit/ 1st mutation one cell
-The second mutation occurs in the same gene (2nd copy) in the same cell
=loss of all tumor suppressor activity
= cancer

two hit hypothesis
difference between familial and non familial forms of cancer
in familial, the first hit/mutation is inherited so it is present in all cells so only one more hit needed for mutation
while in nonfamilial, it is not inherited and two hits are needed in order to have a mutation
second hit is usually what type of mutation
loss of heterozygosity
how does loss of heterozygosity work
if a child is heterozygote at a locus but the tumor tissue has only a single type of allele, mutation would occur where child loses one of its alleles hence losing its heterozygote status
4 mechanisms of 2nd hit that causes persons to lose its normal allele and retain its tumor allele (loss of heterozygosity)
loss through nondisjunction, mitotic recombination, gene deletion, and point mutation
loss of tumor suppressor gene function is a result of
methylation of gene resulting in its silencing - so mutation in DNA silencing can result in tumor
what does cyclin/Cdk do
it hyperphosphorylates Rb so that it no longer represses/binds to ECF so that it can activate S phase genes causing cells to divide
occurs in G1/S phase
what happens if no cyclin/Cdk present
Rb is hypophosphorylated and it continues to bind/repress ECF then it recruits histone deacetylase and histone methylase so it cannot activate the S phase hence hindering transcription –> G1 cell cycle arrrest
what happens if there is a mutation in Rb
cell cycle would not arrest at G1 even if Rb is hypophosphorylated and bound to histone methylase and histone deacetylase, ECF will still bind and cell division will progress —> uncontrolled cell division
all cancer cells show dysregulation of the G1-S checkpoint as a result of mutations in what 4 genes that regulate the phosphorylation of Rb
Rb, CDK4, cyclin D gene, and CDKN2A (p16)
mutation of Rb gene on chromosome 13
retinoblastoma (childhood cancer)
remember two copies of Rb gene have to be mutated to have the cancer
in terms of familial cancers, what is inherited
the first hit is inherited through germline mutation
second hit is through somatic mutation
in non familial cancer/ sporadic cancers, how many mutations are required for manifestations of cancer
two somatic mutation since none is inherited
differences in familial and sporadic cancer
familial - appears autosomal dominant, multiple tumors, bilateral, early onset
sporadic - appears autosomal recessive, simple tumor, unilateral, late onset
despite high penetrance why is it that some people who have germline mutation of cancer do not have cancer?
because the second hit/somatic mutation has not occurred yet
so loss of Rb destroys what checkpoint
G1/S checkpoint
loss of Rb or mutant Rb does what ?
does not bind to ECF hence does not suppress it leading to increased transcriptions of S phase genes leading to unregulated cell division
tumor suppressor that controls both cell birth and cell death
p53
what is p53
transcription factor activated by cell stress particularly DNA damage and it impinges on the G1/S checkpoint
what happens with loss of p53
increased net cell growth and increased frequency in mutation (since no apoptosis)
what exactly does p53 do
arrests cell cycle in G1, activates DNA repair if damage, if DNA damage is beyond repair it activates apoptosis
guardian of the genome
p53
p53 drives the expression of what apoptotic genes
pro-apoptotic Bcl-2 family members, Fas receptors (CD95), IGFBP-3 (sequesters cell survival proteins like IGF1/2 away from receptors)
inherited mutation in p53 and some tp53 genes
Li Fraumeni Syndrome
first hit in Li Fraumeni is from
mother
Li Fraumeni can lead to
different types of cancers - breast, bone, brain, adrenocortical tumors and soft-tissue carcinomas
p53 is regarded as the guardian of the genome
because, in response to DNA damage, this
transcription factor
- Activates the G1/S checkpoint
- Drives expression of DNA repair genes
- Promotes cell cycle arrest
- Initiates apoptosis of badly damaged cells
common inherited cancers
colorectal:
familial adenomatous polyposis (FAP)
hereditary non-polyposis colon cancer (HPNCC): lynch syndrome
breast cancer
mutation in the APC (adenomatous polypsis coli) gene on chromosome 5
FAP 5
what does it mean if person has multiple polyps on colon
it means they have a higher chance of getting cancer and not that they have it - need second mutation to have the disease
it is best to get colon removed
FAP has different mutations on the APC gene meaning that
it has allelic heterogenity
in FAP, the tumor suppressor gene affects _____ involved in the control pathway
b-catenin
normal APC pathway when there is no WNT signal
APC (part of WNT signaling pathway) degrades b-catenin by phosphorylation (ubiquitination) so with low beta catenin level there is no growth
normal APC pathway when there is a WNT signal
destruction complex inactivated, beta catenin not degraded and enters the nucleus where it forms a complex with TCF-4 which activates growth promoting gene
APC pathway when there is a mutation in APC
beta catenin is not phosphorylated and degraded by AFC in absence of WNT signal so it goes into nucleus and binds with TCF-4 where growth is activated
which cells enter oncogene senescence
cells that gain oncogene signaling without loss of p53
which one is an early gate keeper event and which on is late onset - APC and p53
p53 - late
APC - early
mutation of DNA mismatch DNA repair genes (MMR)
HNPCC - hereditary non polyposis colon cancer: lynch syndrome
difference between FAP and HPNCC
FAP has multiple polyps but progresses slowly
HNPCC has few polyps and progresses rapidly
common genes responsible for HNPCC
MSH2 on chromosome 2
MLH1 on chromosome 1
locus heterogenity
genes/proteins not directly involved in control of cell division
mutator genes
lynch syndrome (tumor) exhibits what type of instability
microsatellite instability - short repetitive sequences of DNA
A 28-year old male with family history of early colon cancer (prior to age 50) is examined by colonoscopy. A single large adenomatous polyp is discovered. Which of the following gene mutations is likely?
mutation in MSH2 or MLH1
A 28-year old male with family history of early colon cancer (prior to age 50) is examined by colonoscopy. A single large adenomatous polyp is discovered. Which genomic aberration is most likely found in the tumor tissues
microsatellite instability
breast and ovarian cancer exhibit what phenomenon
locus heterogenity - BRCA1 and BRCA2 gene
also exhibit allelic heterogenity on BRCA1
BRCA1 and BRCA2 are involved in _______ and ________ when DNA can’t be repaired
DNA repair and apoptosis
what happens if loss of BRCA1 gene
cells can replicate with DNA damage —> cancer
HER-2 (Human Epidermal growth factor Receptor 2) over-expression in sporadic breast cancer shows what on the probe
double minute chromosomes - extra chromosomal fragments of DNA
binds to HER2 and prevents binding of EGF to HER2
Herceptin
Herceptin is effective in what tumors
Her2+ tumors but not in Her2- tumors
what does herceptin do
decreased tumor cell proliferation
Possible Direct Roles of Epigenetics in Tumorigenesis
1) Silencing of tumor suppressor loci causing cell overgrowth
2) Loss of imprinting causing activation of growth associated genes (e.g. IGF2)
3) MicroRNAs
what does miRNA do
it targets specific mRNA and silences it
possible effects of cancer on miRNA
reduction of those that could have inhibited oncogene RNA
increase in those that have target suppressor RNA
ALL BAD
Determining changes in the expression of large numbers of genes between two groups is possible with
microarray analysis