True or False: Cancer is the leading cause of death in people over the age of 85, with - PowerPoint Presentation

Slide1

True or False:

Cancer is the leading cause of death in people over the age of 85, with mortality rates continuing to rise.

Slide2

Cancer

Cancer affects approximately 9.6 million Americans

1.4 million cases annually

570,000 deaths annually

For persons younger than the age of 85, cancer is the leading cause of death in the United States since 1999

Annual costs exceeding 180 billion dollars

Major efforts underway for prevention

Mortality rates continue to decrease

Slide3

The most common cancer affecting men is

?

Prostate

Lung

Colorectal

Liver

Slide4

The most common cancer affecting

women

is

?

Breast

Lung

Colorectal

Liver

Slide5

The most

common cause of cancer death in women

is

?

Breast

Lung

Colorectal

Liver

Slide6

Cancer Incidence by Gender

Slide7

Which of the following is NOT one of the six properties essential to cancer growth developed by

by

Hanahan

and

Weinberg?

Self-sufficiency in growth signals

Insensitivity to anti-growth signals

Evading apoptosis

Limited replicative potential

Slide8

Cancer

Defined as abnormal cell growth

Hanahan

and Weinberg Theory

Slide9

Which of the following below is not considered a proto-oncogene

?

Ras

C-

abl

RET

BRCA1

Slide10

Which of the following

proto-oncogene is mutated in colon cancers?

Ras

C-

abl

RET

BRCA1

Slide11

Which of the following below is not considered a

tumor suppressor gene?

BRCA2

P53

Rb1

Erb

B

Slide12

Which of the following below is anti-apoptotic

?

Bcl-2

Bax

CD-95

FasL

Slide13

Tumor Suppressor genes and Proto-oncogenes

Tumor Suppressor Genes

Proto-Oncogenes

APC ( Chromosome 5)

K-

ras

(GTP-

ase

activity)

P53 (Chromosome 17)

RET (chromosome

10)

BRCA 1 (Chromosome 17)

Src

BRCA 2 (Chromosome 13)

C-

myc

Bcl-2 (apoptosis)

DCC (Deleted

in Colon Cancer Gene)

Retinoblastoma

Rb

1 (Chromosome 13)

C-

abl

/

bcr

(Translocation 9:22)



bcr

/

abl

MEN 1

C-sis

vHL

Slide14

Tumor Suppressor genes

Tumor Suppressor Genes

Cancers

APC ( Chromosome 5)

Adenomatous Polyposis Coli

P53 (Chromosome 17)

Li-

Fraumeni

Syndrome - Many

cancers

BRCA 1 (Chromosome 17)

Breast,

ovarian, pancreas, Melanoma, prostate

BRCA 2 (Chromosome 13)

Breast,

ovarian, pancreas, Melanoma, prostate

Bcl-2 (apoptosis)

Retinoblastoma

Rb

1 (Chromosome 13)

Retinoblastoma

MEN 1

MEN 1 syndrome

vHL

Von

Hippel-Lindau

Slide15

Proto-oncogenes

Proto-Oncogenes

Cancers

K-

ras

(GTP-

ase

activity)

Colon Cancer

RET (chromosome

10)

MEN 2a and 2b

Src

Colorectal,

bresat

, melanomas, ovarian

C-

myc

Malignant T-cell lymphomas,

leukemias

, Breast, Colon, lung, cervical,

ovarian, retinoblastoma

DCC (Deleted

in Colon Cancer Gene)

Colon cancer

C-

abl

/

bcr

(Translocation 9:22)



bcr

/

abl

Chronic

Myelogenous

Leukemia

C-sis

Glioblastomas

,

fibrosarcomas

, breast, melanoma

Slide16

Apoptosis

Bcl-2

Bax

Anti

Pro

Slide17

What phase of the cell cycle does DNA replication occur

?

S

G1

G2

M

Slide18

What phase of the cell cycle is most variable

?

S

G1

G2

M

Slide19

What phase of the cell cycle is most vulnerable to radiation therapy

?

S

G1

G2

M

Slide20

What phase of the cell cycle do growth factors affect

?

S

G1

G2

M

Slide21

Which

of the below is not a cell-cycle specific chemotherapy agent that is specific to cell-killing at the S Phase?

Methotrexate

5-FU

Gemcitabine

Paclitaxel

Slide22

Which

of the below is not a cell-cycle specific chemotherapy agent that is specific to cell-killing at the M Phase?

Vincristine

Vinblastine

Paclitaxel

Doxorubicin

Slide23

Cell Cycle

Phase

S

Replication of

DNA

Protein Synthesis

Cells preparing for Division

M

Cell Division – Mitosis

Phase most vulnerable

to radiation

G1

Most variable

phase

Determines Cell Cycle length

Most affected by Growth Factors

Cells can go to GO phase

G2

Check

point for DNA damage prior to Mitosis

G0

Quiescent Phase

Slide24

Cell Cycle Specific Agents

Phase

S

Anti-Metabolites:

Methotrexate- inhibits

dihydrofolate

redutase

(DHFR) inhibits

purine and DNA synthesis (Nephrotoxicity)

5-FU- Inhibits

Thymidylate

Synthase (TS) inhibits purine and DNA synthesis

Gemcitabine- Nucleoside analogue

Topoisomerases:

Etoposide

Topotecan

Anti-tumor antibiotics:

Doxorubicin – DNA

intercalator

(Cardiac Toxicity)

M

Alkaloids:

Microtubule Inhibitors

Vincristine (Peripheral neuropathy)

Vinblastine (Bone

marrow suppression)

Taxanes

:

Promote microtubule formation and stabilization (Peripheral neuropathy)

PaclitaxelDocitaxel

Slide25

Mitosis

Slide26

Which

of the below Targeted Molecular Therapies acts by binding VEGF ?

Trastuzumab

Bevacizumab

Rituximab

Imatinib

Slide27

Which

of the below Targeted Molecular Therapies is used for treatment in Her2

Neu

positive breast cancer?

Trastuzumab

Bevacizumab

Rituximab

Imatinib

Slide28

Which

of the below Targeted Molecular Therapies is not a monoclonal antibody?

Trastuzumab

Bevacizumab

Rituximab

Imatinib

Slide29

Which

of the below

Monoclonal antibodies

functions through a Tyrosine Kinase receptor pathway?

Trastuzumab

Bevacizumab

Rituximab

Imatinib

Slide30

Targeted Therapies

Class

Monoclonal Antibody

Trastuzumab

(Herceptin)

Binds Her2Neu receptor (tyrosine kinase) (Breast

ca

)

Bevacizumab

(

Avastin

)

Binds VEGF (Colon

Ca

)

Rituximab

(

Rituxan

)

Binds B cell CD20 (NHL)

Tyrosine Kinase

Inhibitor

Imatinib

(

Gleevac

)

Binds c-kit (GIST)

Immunotherapy

IFN-α

(melanoma)IL2(melanoma)

Slide31

Which virus is associated with Kaposi’s sarcoma

?

HPV-18

HHV-8

HCV

EBV

Slide32

Which virus is associated with Nasopharyngeal carcinoma

?

EBV

HBV

HCV

HIV

Slide33

Which virus is associated with Post-transplantation

lymphoproliferative

disease

?

EBV

HBV

HCV

HIV

Slide34

Virus

R

elated Cancers

Virus

Cancer

EBV

Burkitt’s

lymphoma

Nasopharyngeal

carcinoma

Post-transplantation

lymphoproliferative

Dz

(PTLD)

HPV

Cervic

al Cancer

HBV

HCV

HDV

Hepatocellular

Carcinoma

HHV-8

Kaposi’s Sarcoma

Slide35

Which of the below tumor markers is a marker for Hepatocellular

carcioma

?

CA 125

CA 19-9

CEA

AFP

Slide36

Which of the below tumor markers is a marker for Small Cell Lung Cancer

?

NSE

CA 19-9

CEA

AFP

Slide37

Tumor Markers

Marker

Cancer

ABC-B5

Melanoma

CEA

Colon Cancer

AFP

Hepatocellular Carcinoma

DCP

Hepatocellular Carcinoma

CA 19-9

Pancreatic

Ca

CA 125

Ovarian and Endometrial

Ca

Beta-HCG

Testicular,

Choriocarcinoma

NSE

Small cell,

Neuroblastom

, Merkel cell tumor

Slide38

A phase II clinical trial answers which of the questions below?

Is it safe and at what dose

Is it effective

Is it better than existing therapy

Which marketing is effective

Slide39

Clinical Trials

Phase

Question

I

Is it safe and at what dose?

II

Is it effective? (based on maximum

tolerated dose/ small population)

III

Is it better than existing therapy? (prospective randomized/ large population)

IV

Implementation and marketing