the hallmarks of cancer · hallmarks of cancer: the next generation review douglas hanahan* and...
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Cancer surgery, circa 1689
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Established 1937
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1971.: Nixon declares “War on Cancer” !2001: Andrew von Eschenbach “eliminate suffering and death”
by 2015 2004.: “Why We're Losing The War On Cancer” Fortune Magazine ..
Age-adjusted
Death rates
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Cancer is the Result of a Multistep Process
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What are the underlying events of carcinogenesis and how do they come about?
Question:
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Cell, Vol. 100, 57–70, January 7, 2000
The Hallmarks of Cancer
Review
Douglas Hanahan* and Robert A. Weinberg †
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Cell, Vol. 144, 646–674, March 4, 2011
Hallmarks of Cancer: The Next Generation
Review
Douglas Hanahan* and Robert A. Weinberg
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Acquired Capabilities of a Cancer Cell
Cell 100, 57–0
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In Vitro Studies
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• Oncogenes – mutated forms of normal cellular genes generally involved in promoting cell proliferation. These mutations result in dominant gain of function. !
• Tumor Suppressor genes – genes whose normal function in regulating proliferation is to stop it. Mutation results in recessive loss of function.
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!Hypothesis: Mutation in one gene associated with each step in progression.
Carcinogenesis is the accumulation of multiple genetic alterations that drive a normal cell to malignancy.
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Hanahan &Weinberg Cell 100:57 2000
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Tumor Heterogeneity
Breastcancer.org
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Reductionist View of a Tumor
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Realistic View of a Tumor
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Normal Mitogenic Growth Stimulation
NucleusGrowth Factor
Transmembrane Receptor
Signal Transduction Proteins
Cytoplasm
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Strategies of Tumor Cell Self-Sufficiency
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Insensitivity to Anti-Growth Signals
TGFβR
Anti-Growth Signal such as TGFβ
Smads
Cell Proliferation
Mad Max
Myc Max
pRB
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MitochondrionSensor Molecules
p53
Cell Death
Antiapoptosis signal
Proapoptosis signal
Regulation of Apoptosis
Effector Molecules
Bcl2
Bax
?Fas
Fas ligand
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Telomeres Your Biological Clock is Ticking
(TTAGG)nTTAGGTTAGGTTAGGTTAGGTTAGG
(TTAGG)nTTAGGTTAGGTTAGGTTAGG
(TTAGG)nTTAGGTTAGGTTAGG
(TTAGG)nTTAGGTTAGG
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Angiogenesis
Region of insufficent blood supply
Angiogenic Factors
Antiangiogenic Factors
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Invasion and Metastasis
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Immune Evasion !Some data supports:
!Selective killing of highly immunogenic tumors, leaving weakly immunogenic ones !Tumors disable parts of the immune system by secreting or recruiting cells that secrete immunosuppressive factors (ex. TGF B) !Tumor cells down-regulate expression of MHC genes
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Tumor-Promoting Inflammation !! Tumor- infiltrating immune cells provide factors which: !
– Stimulate growth – Inhibit cell death – Promote angiogenesis – Degrade extracellular matrices – Induce epithelial-mesenchymal transition – Damage DNA (reactive oxygen species)
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Deregulating Cellular Energetics
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PET SCAN
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Cancer - evolution at a vastly accelerated rate favoring the growing tumor mass over the organism.
Genomic Instability introduces genomic alterations and Natural Selection chooses “the fittest” tumor to survive.
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