Molecular basis of cancer part 1

  2. 2.Neoplasia means “new growth” Greek oncos = tumor British oncologist Willis gave closest definition-―A neoplasm is an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues and persists in the same excessive manner after cessation of the stimuli which evoked the change.‖ Malignant tumors are collectively referred to as cancers, derived from the Latin word for crab
  3. 3. All tumors, benign and malignant, have two basic components  clonal neoplastic cells that constitute their parenchyma  reactive stroma made up of connective tissue, blood vessels, and variable numbers of macrophages and lymphocytes DIFFERENTIATION AND ANAPLASIA  Differentiation- the extent to which neoplastic parenchymal cells resemble the corresponding normal parenchymal cells, both morphologically and functionally;  lack of differentiation called anaplasia In general, benign tumors are well differentiated Malignant neoplasms - wide range of parenchymal cell differentiation, from surprisingly well differentiated to completely undifferentiated
  4. 4. METASTASIS  tumor implants discontinuous with the primary tumor  unequivocally marks a tumor as malignant because benign neoplasms do not metastasize Comparisons between Benign and Malignant Tumors Characteristics Differentiation/anaplasia Benign Well differentiated; structure sometimes typical of tissue of origin Malignant Some lack of differentiation with anaplasia; structure often atypical Rate of growth Usually progressive and slow; may come to a standstill or regress; mitotic figures rare and normal Erratic and may be slow to rapid; mitotic figures may be numerous and abnormal Local invasion Usually cohesive expansile well-demarcated masses that do not invade or infiltrate surrounding normal tissues Locally invasive, infiltrating surrounding tissue; sometimes may be seemingly cohesive and expansile Metastasis Absent Frequently present; the larger and more undifferentiated the primary, the more likely are metastases
  5. 5.What causes Cancer? Cancer is caused by alterations or mutations in the genetic code Can be induced in somatic cells by:  Carcinogenic chemicals  Radiation  Some viruses Heredity - 5% 5
  6. 6.Examples of Inherited Predisposition to Cancer INHERITED CANCER SYNDROMES (AUTOSOMAL DOMINANT) Gene Inherited Predisposition RB Retinoblastoma p53 Li-Fraumeni syndrome (various tumors) p16/INK4A APC Melanoma Familial adenomatous polyposis/colon cancer NF1, NF2 BRCA1, BRCA2 MEN1, RET Neurofibromatosis 1 and 2 Breast and ovarian tumors Multiple endocrine neoplasia 1 and 2 MSH2, MLH1, MSH6 Hereditary nonpolyposis colon cancer PTCH Nevoid basal cell carcinoma syndrome PTEN Cowden syndrome (epithelial cancers) LKB1 Peutz-Jegher syndrome (epithelial cancers) VHL Renal cell carcinomas INHERITED AUTOSOMAL RECESSIVE SYNDROMES OF DEFECTIVE DNA REPAIR Xeroderma pigmentosum Ataxia-telangiectasia Bloom syndrome Fanconi anemia FAMILIAL CANCERS Familial clustering of cases, but role of inherited predisposition not clear for each individual Breast cancer Ovarian cancer Pancreatic cancer
  7. 7.Molecular Basis of Cancer
  8. 8. Nonlethal genetic damage lies at the heart of carcinogenesis  A tumor is formed by the clonal expansion of a single precursor cell that has incurred genetic damage (i.e., tumors are monoclonal). most commonly used method to determine tumor clonality involves the analysis of methylation patterns adjacent to the highly polymorphic locus of the human androgen receptor gene, AR Four classes of normal regulatory genes—the growth-promoting proto-oncogenes, the growth-inhibiting tumor suppressor genes, genes that regulate programmed cell death (apoptosis), and genes involved in DNA repair-are the principal targets of genetic damage Carcinogenesis is a multistep process at both the phenotypic and the genetic levels, resulting from the accumulation of multiple mutations
  9. 9.Even though most malignant tumors are monoclonal in origin, by the time they become clinically evident their constituent cells are extremely heterogeneous. Also they will undergo immune surveillance. Tumor progression and generation of heterogeneity.
  11. 11.Flowchart depicting a simplified scheme of the molecular basis of cancer
  12. 12.SELF-SUFFICIENCY IN GROWTH SIGNALS: ONCOGENES  Genes that promote autonomous cell growth in cancer cells are called oncogenes.  unmutated cellular counterparts are called proto-oncogenes.  Products of oncogene called oncoproteins  sequential steps that characterize normal cell proliferation • The binding of a growth factor to its specific receptor • Transient and limited activation of the growth factor receptor, which, in turn, activates several signal-transducing proteins on the inner leaflet of the plasma membrane • Transmission of the transduced signal across the cytosol to the nucleus via second messengers or by a cascade of signal transduction molecules • Induction and activation of nuclear regulatory factors that initiate DNA transcription • Entry and progression of the cell into the cell cycle, ultimately resulting in cell division
  13. 13.Selected Oncogenes, Their Mode of Activation, and Associated Human Tumors
  14. 14.Selected Oncogenes, Their Mode of Activation, and Associated Human Tumors
  15. 15. Growth Factors. - switching from normal paracrine loop to autocrine loop. -e.g. PDGF in many glioblastomas, TGF-α Growth Factor Receptors. -transmembrane proteins with an external ligand-binding domain and a cytoplasmic tyrosine kinase domain -the kinase is transiently activated by binding of the specific growth factors, followed rapidly by receptor dimerization and tyrosine phosphorylation of several substrates switching on the signaling cascade. The oncogenic versions of these receptors are associated with constitutive dimerization and activation without binding to the growth factor.
  16. 16.RET protooncogene, a receptor tyrosine kinase, exemplifies oncogenic conversion via mutations and gene rearrangements  RET protein- receptor for the glial cell line–derived neurotrophic factor  structurally related proteins that promote cell survival during neural development  normally expressed in neuroendocrine cells, such as parafollicular C cells of the thyroid, adrenal medulla, and parathyroid cell precursors  Point mutations in the RET proto-oncogene are associated with dominantly inherited MEN types 2A and 2B and familial medullary thyroid carcinoma  Other example- FLT-3 (FMS like Tyrosine Kinase3) mutation in myeloid leukaemia.  > 90% of GIST-mutation in the receptor tyrosine kinase c-KIT or PDGFR. Imatinib mesylate is the T/t – a tyrosine kinase inhibitor.
  17. 17.more common than mutations is overexpression of normal forms of growth factor receptor  Two members of the epidermal growth factor (EGF) receptor family best described  normal form of ERBB1, the EGF receptor gene, overexpressed in up to 80% of squamous cell carcinomas of the lung, in 50% or more of glioblastomas and in 80% to 100% of head and neck tumors  ERBB2 gene (also called HER-2/NEU), the second member of the EGF receptor family, amplified in approximately 25% of breast cancers and in human adenocarcinomas arising within the ovary, lung, stomach, and salivary glands
  18. 18.Signal-Transducing Proteins.  most well-studied example of a signal transducing oncoprotein is the RAS family of guanine triphosphate (GTP)binding proteins (G proteins) The RAS Oncogene -three types in human genome (HRAS, KRAS, NRAS) -Point mutation of RAS family genes is the single most common abnormality of proto-oncogenes in human tumors. -carcinomas (particularly from colon and pancreas) have mutations of KRAS, bladder tumors have HRAS mutations, and hematopoietic tumors bear NRAS mutations. RAS plays an important role in signaling cascades downstream of growth factor receptors, resulting in mitogenesis.
  19. 19.Model for action of RAS genes.
  20. 20.Transcription Factors  Transcription factors contain specific amino acid sequences or motifs that allow them to bind DNA or to dimerize for DNA binding  A host of oncoproteins, including products of the MYC, MYB, JUN, FOS, and REL oncogenes, are transcription factors that regulate the expression

    of growth-promoting genes, such as cyclins.  MYC is most commonly involved in human tumors The MYC Oncogene  expressed in virtually all eukaryotic cells  belongs to the immediate early response genes, which rapidly induced when quiescent cells receive a signal to divide  the range of activities modulated by MYC very broad  includes histone acetylation, reduced cell adhesion, increased cell motility, increased telomerase activity, increased protein synthesis, decreased proteinase activity  one of a handful of transcription factors that can act in concert to reprogram somatic cells into pluripotent stem cells

  21. 21.Cyclins and Cyclin-Dependent Kinases  ultimate outcome of all growth-promoting stimuli is the entry of quiescent cells into the cell cycle.  orderly progression of cells through the various phases of the cell cycle is orchestrated by cyclin-dependent kinases (CDKs)  CDKs activated by binding to cyclins, so called because of the cyclic nature of their production and degradation  The CDK-cyclin complexes phosphorylate crucial target proteins that drive the cell through the cell cycle  cyclins D, E, A, and B appear sequentially during the cell cycle and bind to one or more CDK
  22. 22.Schematic illustration of the role of cyclins, CDKs, and CDK inhibitors (CDKIs) in regulating the cell cycle
  23. 23.Internal controls of the cell cycle(checkpoints)  G1/S transition  G2/M  S phase, the point of no return in the cell cycle  delay in cell cycle progression provides the time needed for DNA repair  if the damage not repairable, apoptotic pathways activated to kill the cell.  G2/M checkpoint monitors the completion of DNA replication, particularly important in cells exposed to ionizing radiation.  Defects in cell cycle checkpoint components, a major cause of genetic instability in cancer cells.
  25. 25. Tumor suppressor genes apply brakes to cell proliferation  RB and p53, part of a regulatory network that recognizes genotoxic stress from any source, and responds by shutting down proliferation.  The RETINOBLASTOMA (RB) gene  RB, the first, and prototypic, tumor suppressor gene discovered.  Knudson’s canonical “two-hit” hypothesis of oncogenesis  Two mutations (hits), involving both alleles of RB at chromosome locus 13q14, are required to produce retinoblastoma.
  26. 26. In familial cases, children inherit one defective copy of the RB gene in the germ line (one hit);  Retinoblastoma develops when the normal RB allele is mutated in retinoblasts as a result of spontaneous somatic mutation (second hit).  Loss of heterozygosity
  27. 27.RB protein, the product of the RB gene. -ubiquitously expressed nuclear phosphoprotein -plays a key role in regulating the cell cycle. -RB exists in active hypophosphorylated state in quiescent cells -inactive hyperphosphorylated state in the G1/S cell cycle transition POLICING THE G1-S CHECK POINT
  28. 28.p53: Guardian of the Genome  located on chromosome 17p13.1  most common target for genetic alteration in human tumors.  A little over 50% of human tumors contain mutations in this gene.  Homozygous loss of p53 occurs in virtually every type of cancer, including carcinomas of the lung, colon, and breast—the three leading causes of cancer death  Mutation occurs usually somatically, not germline.  If occurs germline, only one HIT required for carcinogenesis – called Li-Fraumeni syndrome  P53, transcription factor that sense cellular stress, such as DNA damage, shortened telomeres, and hypoxia.
  29. 29.p53 thwarts neoplastic transformation by three interlocking mechanisms: -activation of temporary cell cycle arrest (quiescence), - induction of permanent cell cycle arrest (senescence), -triggering of programmed cell death (apoptosis).
  30. 30.-In nonstressed, healthy cells, p53 has a short halflife (20 minutes), because of its association with MDM2, a protein that targets it for destruction.  When the cell is stressed, p53 undergoes posttranscriptional modifications that release it from MDM2 and increase its half-life. ?? How p53 repress gene expression?? MicroRNA  Targets of mir34s include pro-proliferative genes such as cyclins, and anti-apoptotic genes such as BCL2.  p53 regulation of mir34 explains, at least in part, how p53 is able to repress gene expression, and it seems that regulation of this miRNA is crucial for the p53 response.
  31. 31.Small guy with big clubs- the microRNA blocking mir34 severely hampered the p53 response in cells
  32. 32. The key initiators of the DNA-damage pathway are two related protein kinases: -ataxia-telangiectasia mutated (ATM) -ataxia-telangiectasia and Rad3 related (ATR).  p53-mediated cell cycle arrest may be considered the primordial response to DNA damage  p21 inhibits cyclin-CDK complexes and phosphorylation of RB, thereby preventing cells from entering G1 phase  p53-induced senescence is a permanent cell cycle arrest  p53-induced apoptosis of cells with irreversible DNA damage is the ultimate protective mechanism against neoplastic transformation
  33. 33.APC/β-Catenin Pathway chromosome 5q21  APC, a component of the WNT signaling pathway, which has a major role in controlling cell fate, adhesion, and cell polarity during embryonic development.  WNT signaling is required for self-renewal of hematopoietic stem cells.  An important function of the APC protein is to downregulate β-catenin. In the absence of WNT signaling APC causes degradation of β-catenin, preventing its accumulation in the cytoplasm.  mutations in the β-catenin gene are present in more than 50% of hepatoblastomas and in approximately 20% of hepatocellular carcinomas.
  34. 34.The role of APC in regulating the stability and function of β-catenin.
  35. 35.Other tumour suppressor genes  INK4a/ARF encodes two protein products1) p16/INK4a CDKI, which blocks cyclin D/CDK2-mediated phosphorylation of RB, keeping the RB checkpoint in place. 2) p14/ARF, activates the p53 pathway by inhibiting MDM2 and preventing destruction of p53.  p16 in particular is crucial for the induction of senescence.  Mutations at this locus detected in bladder, head and neck tumors, acute lymphoblastic leukemias, and cholangiocarcinomas.
  36. 36. The TGF-β Pathway  In most normal epithelial, endothelial, and hematopoietic cells, TGF-β is a potent inhibitor of proliferation  regulates cellular processes by binding to a serinethreonine kinase complex composed of TGF-β receptors I and II.  TGF-β signaling leads to repression of c-MYC, CDK2, CDK4, and cyclins A and E.  In 100% of pancreatic cancers and 83% of colon cancers, at least one component of the TGF-β pathway is mutated.
  37. 37.PTEN (Phosphatase and tensin homologue)  a membrane-associated phosphatase encoded by a gene on chromosome 10q23  mutated in Cowden syndrome, an autosomal dominant disorder marked by frequent benign growths  acts as a tumor suppressor by serving as a brake on the prosurvival/ pro-growth PI3K/AKT pathway  this pathway normally stimulated (along with the RAS and JAK/STAT pathways) when ligands bind to receptor tyrosine kinases and involves a cascade of phosphorylation events.
  38. 38.38 Revolution in cancer treatment: ‘Smart Bullets Period’
  39. 39.Summary of 30 years of research (1971-2001)
  40. 40.40 HERCEPTIN Bilimsel Araştırmaların STI-571 ERCEPTİN Kanserle Savaşa Katkısı
  41. 41.Thank you

Category: Cancer-2

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