Chapter 6 Multiple choice questions

. Which of the following statements about metastasis are true?

Metastasis is the spread of tumour cells from their primary location to distant sites in the body.

Metastasis is the major cause of cancer-related deaths.

The secondary site colonized by metastatic cells is always close to the site of the primary tumour.

The tumour microenvironment plays a critical role in metastatic spread.

A critical step in the metastatic spread of epithelial tumour cells is transition to a more mesenchymal state.

. Which of the following statements about epithelial mesenchymal transition are true and which are false?

Metastases always have mesenchymal features.

The Wnt signalling pathway can drive EMT.

Some non-coding RNAs are mediators of EMT.

Vimentin is a mesenchymal marker.

. Which of the following are mechanisms of drug resistance?

Increased levels of DNA repair counteract the effect of DNA damaging drugs.

Tumour cells are resistant to cell death.

Influx of drug into cancer cells is increased.

Drugs are exported from the tumour cell before they can act.

. Which of these statements about oncolytic viruses is true?

Oncolytic viruses are designed to preferentially replicate in cancer cells.

Oncolytic viruses are always designed to replace faulty genes in tumour cells.

Oncolytic viruses have been trialled that target cells with mutant TP53.

A genetically modified herpes simplex virus has been approved for patients with advanced melanoma.

. Which of the following statements about tumour biomarkers are true?

Prostate-specific antigen is a prognostic biomarker for prostate cancer.

Mutant isocitrate dehydrogenase is a prognostic biomarker for glioma.

Promoter methylation of HOXA9 is a prognostic biomarker for lung cancer.

HER2 expression is a predictive biomarker for breast cancer.

. Which of the following statements about EMT-activating transcription factors are true?

Induce the expression of mesenchymal markers

Are activated in different combinations within different cancers

Are activated by hypoxia and stromal cells within the TME (e.g. macrophages)

Non-coding RNAs are not involved in mediating their activity.

. Which of the following statements relating to challenges associated with cancer therapy are true?

Some tumour cells may not respond to treatment and repopulate.

The molecular profile of tumours evolves as the disease progresses, and this makes treatment difficult.

Treatment can alter the molecular landscape of the tumour enriching for drug-resistant cells.

Technologies do not exist to help us track the molecular profile of single cells within a tumour, and thus our approach to personalized therapy is limited.

. Which of the following statements about therapeutic cancer vaccines are true?

Uses tumour-associated antigens to invoke a T cell immune response against the tumour

Vaccines can be protein- or nucleic acid-based but not whole cell-based.

Vaccines that use tumour-associated antigens can invoke an immune response against normal tissues as well as cancer tissues.

The use of neoantigens in the production of therapeutic vaccines could enhance their effectiveness.

. Which of the following statements relating to metastatic colonization are true?

The formation of a pre-metastatic niche supports the survival of circulating tumour cells at secondary tumour sites.

The development of a pre-metastatic niche does not involve communication between the primary tumours and the secondary sites.

Circulating tumour cells arriving at secondary tumour sites may remain dormant for many years before growth occurs.

It is impossible to know in which organs secondary tumours may arise.

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