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334 Name _________________________

Exam IV, Chapters 13.6 -14 and clinical cancer 5-4-2012
T, F or S (16 points, do 8 of 9, if F, explain why)

_____1) In most normal tissues the balance between angiogenic and anti-angiogenic factors favors

_____2) Avastin (bevacizumab) is an example of a humanized monoclonal antibody that has been
successfully used to treat colon and other cancers.

_____3) E-cadherin is reduced and no longer present in the plasma membrane of invasive cells but
still present in the membranes of tumor cells in the tumor center.

_____4) BRCA1 and BRCA2 mutations are the only two genes associated with hereditary breast

_____5) In the word CAUTION, the letter “T” stands for tumor!

_____6) Circulating tumor cells were only found in metastatic epithelial cancers providing
evidence for the early model of metastasis.

_____7) Aromatase inhibitors prevent the conversion of testosterone to estradiol.

_____8) In a human pedigree analysis, vertical transmission of a trait presence in both sexes
suggests an autosomal dominant inheritance.

_____9) Farnesylation inhibitors were a targeted therapy meant to affect ras signaling.

Matching (4 points):
_____1. expression of vimentin A. good prognostic factor
_____2. Her2/neu+ breast cancer B. bad prognostic factor
_____3. presence of MRP proteins
_____4. VEGF+ expressing tumor
_____5. presence of CTCs
_____6. presence of hENT proteins
_____7. hyperdiploidy in ALL
_____8. rapid early response in ALL

Part II - Short essays, 8 points each (40 points)

1. Do A and B
A. Discuss three different families of standard chemotherapeutic drugs, how they work and the concept of combination
B. Discuss one novel approach to cancer treatment that you think is most promising.

2. We covered a Friday paper about a selective kinase inhibitor known as Gleevec, watched some videos and discussed
a case study in which Gleevec was used as the treatment. Based on that amassed knowledge:
a. What did you learn about its specificity,
b. its effects on in vitro tumor cell growth,
c. its effects on IL-3 induced cell growth of normal cells.
d. For what cancer was it first used in clinical trials?
e. What is the mechanism for its chemotherapeutic effects?

3. List four cancers and the diagnostic tests allowing these cancers to be detected early.

4. Do A and B
A. Describe the four ways in which leukemias can be classified.
B. Discuss the basis for, and results of, one cancer prevention clinical trial

5. Describe the staging of colon cancer OR breast cancer.

Define or describe 8 of the following 10 questions (16 points):

a. an adverse effect of tamoxifen

b. Efaproxiral

c. Distinguish between a blocking agent and a suppressing agent

d. hMSH2

e. Screening for prostate cancer- why the controversy?

f. What are meant by the terms “Adjuvant chemotherapy” and “neoadjuvant therapy?

g. Four recommendations for preventing cancer.

h. Three phases of CML

i. Relationship between purvalanol and myc expression

j. Relationship between purvalanol and CDK1 and survivin

k. Part III - Long Essays

1. (12 points) In the future you are a multi-millionaire capable of setting up a foundation to support cancer research in
the amount of one million dollars. Three research groups are asking for this money:
a. prevention
b. screening and early diagnosis
c. treatment
A. Decide how much money each group should receive and justify it with a paragraph of support for each allocation.
B. Assume you are the representative for the group receiving the least amount of money. Write a one-paragraph
rebuttal to the justification letter you received.

2. (12 points)
Invasion and metastasis were important topics in the fourth quarter of the class as was paper 14 that looked at the role
of mesenchymal stem cells. Explain the steps in the invasive/metastatic process, EMT and relate it to role of the
mesenchymal stem cells in breast cancer metastasis.