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Hallmarks of cancer and its enabling factors (Oncology and Public Health) $3.16
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Hallmarks of cancer and its enabling factors (Oncology and Public Health)

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Hallmarks of cancer and its enabling factors elaborated. Part of the course Oncology and Public Health (minor Biomedical Topics in Health Care).

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  • October 18, 2021
  • 2
  • 2020/2021
  • Class notes
  • Dr. h.r.w. pasman
  • All classes
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Hallmarks of cancer + enabling factors
Hallmarks
1. Self-sufficiency in growth signals
 Tumors have the capacity to proliferate without external stimuli, usually as a consequence of
oncogene activation
 Oncogenes are created by mutations in proto-oncogenes and encode proteins called
oncoproteins that have the ability to promote cell growth in the absence of normal growth-
promoting signals
 Fight with EGFR inhibitors
2. Insensitivity to growth-inhibitory signals
 Tumors may not respond to molecules that inhibit the proliferation of normal cells, usually
because of inactivation of tumor suppressor genes than encode components of these growth
inhibitory pathways
 Fight with cyclin-dependent kinase inhibitors
3. Altered cellular metabolism
 Tumor cells undergo a metabolic switch to aerobic glycolysis Warburg effect enables the
synthesis of macromolecules and organelles that are needed for rapid cell growth
o Aerobic glycolysis used to visualize tumors by PET scanning
 Fight with aerobic glycolysis inhibitors
4. Evasion of apoptosis
 Tumors are resistant to programmed cell death
 Intrinsic and extrinsic
o Activation of protease (normally inactive) initiates proteolytic cascade
 Fight with proapoptotic BH3 mimetrics
5. Limitless replicative potential (immortality)
 Tumors have unrestricted proliferative capacity, a stem cell-like property that permits tumor
cells to avoid cellular senescence and mitotic catastrophe
 Reactivation of telomerase  telomere maintenance
 Fight with telomerase inhibitors
6. Sustained angiogenesis
 Tumors, like normal cells, are not able to grow without a vascular supply to bring nutrients
and oxygen and remove waste products tumors must induce angiogenesis
o Vascular endothelial growth factor (VEGF) and thrombosponding-1 (TSP-1)
o Increased productions of angiogenic factors/loss of angiogenic inhibitors tumor
cells/inflammatory cells
o Hypoxia relative lack of oxygen stimulates production of pro-angiogenic
cytokines
 Fight with VEGF signaling inhibitors
7. Ability to invade and metastasize
 Arise from the interplay of processes that are intrinsic to tumor cells and signals that are
initiated by the tissue environment
 Complex invasion-metastasis cascade
i. Loosening of cell-cell contacts by inactivation of E-cadherin several pathways
ii. Degradation of ECM proteolytic enzymes secreted by tumor/stromal cells
1. MMPs/cathepsins
iii. Attachment to novel ECM components proteolytic enzymes growth factors
iv. Migration of tumor cells prediction by primary site of tumor
 Fight with HCF/c-MET inhibitors
8. Ability to evade host immune system
 Cancer cells exhibit a number of alterations that allow them to evade the host immune
response
 Fight with immune activating anti-CRLA4 mAb

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