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Event: 1971
Key Event Title
Increased, tumor growth
Short name
Biological Context
Level of Biological Organization |
---|
Organ |
Organ term
Key Event Components
Process | Object | Action |
---|---|---|
Breast carcinoma | BRCA1-A complex | increased |
Key Event Overview
AOPs Including This Key Event
AOP Name | Role of event in AOP | Point of Contact | Author Status | OECD Status |
---|---|---|---|---|
AhR activation to metastatic breast cancer | KeyEvent | Louise Benoit (send email) | Under Development: Contributions and Comments Welcome | Under Development |
Taxonomic Applicability
Term | Scientific Term | Evidence | Link |
---|---|---|---|
Homo sapiens | Homo sapiens | High | NCBI |
Life Stages
Life stage | Evidence |
---|---|
Adults | High |
Sex Applicability
Term | Evidence |
---|---|
Mixed | High |
Key Event Description
Tumor growth refers to the increase in size of a cancer due to the uncontrolled proliferation of cells. The mechanisms have been detailed in Hanahan et al. hallmarks of cancer:
- Initiation: Tumor growth often begins with the initiation of genetic alterations in normal cells. This can result from mutations caused by various factors such as exposure to carcinogens, genetic predisposition, or viral infections.
- Uncontrolled Cell Proliferation: One of the hallmark features of tumor growth is uncontrolled cell division. Initiating mutations in key regulatory genes, such as oncogenes and tumor suppressor genes, disrupt normal cell cycle control, leading to continuous and unregulated cell proliferation. The PI3K/AKT/mTOR pathway regulates cell growth, proliferation, and survival. Mutations in genes like PTEN, a negative regulator of this pathway, can lead to its hyperactivation, promoting tumor growth (Janaku, Paplomatta). The MAPK is involved in cell proliferation, differentiation, and survival. Mutations in genes like BRAF and KRAS can activate this pathway, contributing to uncontrolled cell growth and tumor development (Steelman, Guo).
- Angiogenesis: Tumors require a blood supply for sustained growth. Angiogenesis, the formation of new blood vessels, is induced by the tumor to ensure a nutrient and oxygen supply. Tumor cells release pro-angiogenic factors, promoting the development of a network of blood vessels within and around the tumor (Nishida).
- Metabolic Adaptations: Tumor cells often exhibit altered metabolism, characterized by increased glycolysis even in the presence of oxygen (Warburg effect). This metabolic shift supports the high energy demands of rapidly dividing cells (Pham).
- Tumor Microenvironment: Tumor growth involves interactions with the surrounding microenvironment, including stromal cells, immune cells, and the extracellular matrix. Tumor cells can influence their microenvironment to promote their survival and expansion. Fibroblasts transform into cancer associated fibroblasts to support tumor growth by producing growth factors and promoting angiogenesis (Asif).
- Immune Evasion: Malignant tumors can develop mechanisms to evade the immune system. This may involve downregulation of antigens, inhibitory signals to immune cells, or the recruitment of immunosuppressive cells, allowing the tumor to escape immune detection and attack (Hiam).
- Invasion and Metastasis: Malignant tumors can invade nearby tissues and, in advanced stages, metastasize to distant organs. Invasion involves the penetration of tumor cells into surrounding tissues, while metastasis is the spread of cancer cells to other parts of the body via the bloodstream or lymphatic system.
- Tumor Dormancy: In some cases, tumor growth may enter a state of dormancy, where the proliferation of cancer cells is temporarily halted. Dormant tumors can later resume growth, posing challenges in terms of early detection and treatment (Endo).
Detailed here are key molecular mechanisms associated with breast tumor growth (Hanahan):
- Genetic Mutations: Genetic alterations in key oncogenes (e.g., HER2, MYC, PIK3CA) promote cell proliferation whereas mutations in tumor suppressor genes (e.g., TP53, BRCA1, BRCA2) remove inhibitory controls on cell growth. (Knudson)
- Hormone Receptor Signaling: ER-positive breast cancers (70% of cancers) respond to estrogen stimulation, promoting cell proliferation. Endocrine therapies targeting ER signaling are effective in treating these cancers (Elikatkin).
- HER2/Neu overexpression : Amplification or overexpression of the human epidermal growth factor receptor 2 (HER2) promotes cell growth and survival (Slamon, Elikatkin).
- PI3K/AKT/mTOR Pathway Activation: Mutations in the PIK3CA gene or activation of PI3K signaling pathway promotes cell survival and proliferation. Phosphoinositide 3-kinase (PI3K) activation leads to downstream signaling through AKT and mTOR, promoting cell growth and protein synthesis (Janku, Paplomata)
- MAPK pathway: This pathway is involved in cell proliferation, differentiation, and survival. Mutations in this pathway can also contribute to breast cancer development (Steelman).
- Cell Cycle Regulation: Dysregulation of cyclin-dependent kinase (CDK) and cyclin complexes controls the cell cycle progression. Inactivation of the p16 tumor suppressor and retinoblastoma protein (pRB) pathway contributes to uncontrolled cell cycle progression (Witkiewicz).
- Apoptosis Evasion: Overexpression of anti-apoptotic proteins (e.g., Bcl-2, Bcl-xL) inhibits programmed cell death. Mutations or inactivation of pro-apoptotic proteins (e.g., p53) hinders apoptotic responses.
- Angiogenesis Stimulation: Vascular endothelial growth factor (VEGF) and its receptors stimulate angiogenesis, ensuring a blood supply for tumor growth. Hypoxia-inducible factor 1-alpha (HIF-1α) activates angiogenic responses in low-oxygen conditions.
- Epithelial-Mesenchymal Transition (EMT): Downregulation of adhesion molecules (e.g., E-cadherin) leads to increased cell mobility. Acquisition of mesenchymal characteristics enhances the ability of tumor cells to invade surrounding tissues (Drasin).
- Extracellular Matrix (ECM) Remodeling: Overexpression of MMPs facilitates ECM degradation, enabling tumor invasion.
- Metastasis Formation: Tumor cells invade surrounding tissues and enter blood or lymphatic vessels. Ability of tumor cells to survive in the bloodstream. Tumor cells exit circulation, invade distant tissues, and establish secondary tumors.
How It Is Measured or Detected
Many different assays can be used to measure tumor growth directly:
- Clinical measurement and palpation
- Histopathology with fluorescence imaging, dyes or weight
- Serum Biomarkers
- Imagery using caliper measurement on Magnetic Resonance Imaging (MRI), Computed Tomography (CT), Positron Emission Tomography (PET), or ultrasound can provide detailed images for volume calculation.
- Positron Emission Tomography (PET) Imaging : measurement of metabolic activity using radioactive tracers.
- In vivo models: xenograft tumor models, orthotopic models, genetically engineered mouse models
Indirect assays can also be used:
- Bioluminescence Imaging (BLI): Measurement of light emitted by luciferase-expressing tumor cells.
- Flow Cytometry: Quantification of tumor cells based on DNA content.
- Cell Proliferation Assays (MTT/MTS, BrdU)
- Colony formation
Domain of Applicability
Human, mice
References
Asif PJ, Longobardi C, Hahne M, Medema JP. The Role of Cancer-Associated Fibroblasts in Cancer Invasion and Metastasis. Cancers (Basel). 2021 Sep 21;13(18):4720. doi: 10.3390/cancers13184720. PMID: 34572947; PMCID: PMC8472587.
Witkiewicz AK, Knudsen ES. Retinoblastoma tumor suppressor pathway in breast cancer: prognosis, precision medicine, and therapeutic interventions. Breast Cancer Res. 2014 May 7;16(3):207. doi: 10.1186/bcr3652. PMID: 25223380; PMCID: PMC4076637.
Eliyatkın N, Yalçın E, Zengel B, Aktaş S, Vardar E. Molecular Classification of Breast Carcinoma: From Traditional, Old-Fashioned Way to A New Age, and A New Way. J Breast Health. 2015 Apr 1;11(2):59-66. doi: 10.5152/tjbh.2015.1669. PMID: 28331693; PMCID: PMC5351488.
Phan LM, Yeung SC, Lee MH. Cancer metabolic reprogramming: importance, main features, and potentials for precise targeted anti-cancer therapies. Cancer Biol Med. 2014 Mar;11(1):1-19. doi: 10.7497/j.issn.2095-3941.2014.01.001. PMID: 24738035; PMCID: PMC3969803.
Nishida N, Yano H, Nishida T, Kamura T, Kojiro M. Angiogenesis in cancer. Vasc Health Risk Manag. 2006;2(3):213-9. doi: 10.2147/vhrm.2006.2.3.213. PMID: 17326328; PMCID: PMC1993983.
Drasin, D.J., Robin, T.P. & Ford, H.L. Breast cancer epithelial-to-mesenchymal transition: examining the functional consequences of plasticity. Breast Cancer Res 13, 226 (2011). https://doi.org/10.1186/bcr3037
Paplomata E, O'Regan R. The PI3K/AKT/mTOR pathway in breast cancer: targets, trials and biomarkers. Ther Adv Med Oncol. 2014 Jul;6(4):154-66. doi: 10.1177/1758834014530023. PMID: 25057302; PMCID: PMC4107712.
Guo YJ, Pan WW, Liu SB, Shen ZF, Xu Y and Hu LL: ERK/MAPK signalling pathway and tumorigenesis (Review). Exp Ther Med 19: 1997-2007, 2020
Hiam-Galvez, K.J., Allen, B.M. & Spitzer, M.H. Systemic immunity in cancer. Nat Rev Cancer 21, 345–359 (2021). https://doi.org/10.1038/s41568-021-00347-z
Endo H, Inoue M. Dormancy in cancer. Cancer Sci. 2019 Feb;110(2):474-480. doi: 10.1111/cas.13917. Epub 2019 Jan 11. PMID: 30575231; PMCID: PMC6361606.
Slamon, D. J., Godolphin, W., Jones, L. A., Holt, J., Wong, S. G., Keith, D. E., ... & McGuire, W. L. (1989). Studies of the HER-2/neu proto-oncogene in human breast and ovarian cancer. Science (New York, N.Y.), 248(4960), 787-792. https://pubmed.ncbi.nlm.nih.gov/2470152/
Hanahan, D., & Weinberg, R. A. (2000). The hallmarks of cancer. Cell, 100(1), 57-70. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5446472/
Knudson, A. G. (2000). Two-hit hypothesis for inherited breast cancer: an update. Carcinogenesis, 21(3), 439-448. https://pubmed.ncbi.nlm.nih.gov/9212799/
Janku, F., Yap, T. A., & Westin, J. (2018). Targeting the PI3K pathway in human cancer: rationale and emerging clinical landscapes. Journal of Clinical Oncology, 36(15), 1550-1562. https://pubmed.ncbi.nlm.nih.gov/29508857/
Steelman, L. S., Chappell, W. P., deCarvalho, T. B., Lowe, S., & Davies, M. (2004. Ras/Raf/MEK/