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Familial Cancer General Principles • Mutations inherited through germ cells contribute to a minority of tumours • Two hits usually needed germline/somatic • Germline mutations in repressor genes may act in a recessive or dominant negative way • Sporadic tumours may acquire mutations in a similar way to genetic tumours • Different germ-line mutations may have a common end-point • Germline mutations tend to affect specific cell types • Defective DNA repair results in increased CA risk Strong familial link • Retinoblastoma - age<4 • Bilateral cancers familial – unilateral somatic • Onl;y affects eye and bone • Chr 13q14 deletions common Wilm’s tumour • Gene on Chr 11p13 • Renal cancers – one hit only needed • WT-1 inhibits IGF2 EGF PDGF Li-Frameini syndrome • P53 mutations • Breast, sarcoma, lymphoma, brain • Development of cancer is a late event Breast Cancer • • • • Familial Breast Cancer BRCA1 and BRCA2 Mutations affect both males and females Expression of BRCA1 increased at G1 – increased by oestrogens BRCA1 BRCA2 BRCA function in DNA repair Non-homologous End-joining Single Strand Annealing Recombination APC • Adenomatous Polyposis Coli mutated in – Familial Adenomatous Polyposis (FAP) • Incidence 1:7,000. • Colon cancer -> 50% US population / age 70 • Inherited forms 15% of total • FAP patients develop many adenomas outside colon – Skin, eye, brain, osteomas APC • • • • • APC 5q21; Ubiquitously expressed, 2843 AA Functions as oligomer Binds -catenin, cytoskeleton Can induce apoptosis Mutation site influences phenotype – Attenuated polyposis 1-157 – Classic polyposis 169-1600 – CHRPE 463-1387 – Gardeners syndrome 1403-1578 • 80% sporadic colon cancers have mutant APC • Loss of APC C-terminal usual APC • Binds -catenin (armadillo) -catenin binds cadherin (cell adhesion molecule) -catenin binds & activates Tcf/Lef transcription factors – APC may inhibit -catenin signalling -catenin similar to plakoglobin • May function in Wingless / Wnt signalling pathway – Signal promotes APC/ -catenin binding • inhibits Tcf/Lef activation – Wnt involved in breast cancer in mice E-cadherin a-Cat -catenin -catenin -catenin APC Actin Transcription MTs -catenin {APC pathway} Cadherins and Catenins in Cancer