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Genes altered in cancer typically: • Have a positive role in cell division • Have a negative role in cell division • Have a role in the maintenance of DNA integrity Protooncogenes Oncogenes Too much of a good thing…. Src Conversion of a Protooncogene an Oncogene Change gene Expression / Protein Production Alter promoter utilization by METHYLATION Alter promoter utilization Alter promoter utilization by POINT MUTATION Frequency of TERT promoter mutations in human cancers. Abstract Reactivation of telomerase has been implicated in human tumorigenesis, but the underlying mechanisms remain poorly understood. Here we report the presence of recurrent somatic mutations in the TERT promoter in cancers of the central nervous system (43%), bladder (59%), thyroid (follicular cell-derived, 10%) and skin (melanoma, 29%). In thyroid cancers, the presence of TERT promoter mutations (when occurring together with BRAF mutations) is significantly associated with higher TERT mRNA expression, and in glioblastoma we find a trend for increased telomerase expression in cases harbouring TERT promoter mutations. Both in thyroid cancers and glioblastoma, TERT promoter mutations are significantly associated with older age of the patients. Our results show that TERT promoter mutations are relatively frequent in specific types of human cancers, where they lead to enhanced expression of telomerase. Nat Commun. 2013;4:2185. Alter promoter by TRANSLOCATION Chromosome 14 with translocation Chromosome 8 with translocation Viral driver Increase the number of copies of a gene Increase the number of copies of a gene Increase the amount of mRNA Transcription Translation Increase the amount of mRNA Increase protein production by:: • Promoter mis-use • • • • Decreased Methylation Point Mutation Translocation Viral Expression • Increase copy number • In DNA • Of RNA/Protein Conversion of a Protooncogene an Oncogene Change the function of a gene product DNA Point Mutation DNA Deletion / Protein Truncation Chromosomal Translocation Decrease Turnover Increase protein activity by:: • Advantageous DNA mutation • Point mutation • Deletion/truncation • Creation of a fusion protein • Decrease protein turnover • Inhibit destruction