6.13 Discussion Questions

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  1. What are some limitations of DNA sequencing?  What kind of experiments are better suited to genotyping?
     
  2. As whole genome sequencing becomes more common in the clinic, physicians run into a number of ethical dilemmas.  Suppose a first degree relative of a breast cancer patient is eligible for whole genome sequencing to determine her risk of breast cancer incidence.  While the relative does not share the same genotype of the breast cancer patient and has typical risk for breast cancer, the physicians found something else deleterious which predisposes the relative to skin cancer.  What are the physicians entitled to disclose to the relative?  How will our current idea informed consent change with the introduction of whole genome sequencing to the clinic?
     
  3. A TPMT genetic test was performed on a population of patients, and it was found that 5% have decreased TPMT activity. Thinking back to Azathioprine metabolism, what would happen if you administered the typical dosage of Azathioprine? What kind of adjustments would you have to make to their treatment plan?
     
  4. What are the advantages and disadvantages in using biomarkers as prognostic tools?
     
  5. Name one example of cancer immunotherapy, and discuss its mechanism of action.
     
  6. Discuss one way for the government/regulatory bodies to better undertake the issue of treating 'orphan' populations. Is it realistically achievable?
     
  7. Considering the options available for DNA sequencing, if it were necessary to advise an patient and his or her family which option/generation of sequencing to undergoe, assuming they could choose, which option would you advise them to select to best create a personalized therapy for them?  Consider costs, effectiveness, limitations, sequencing accuracy and molecular mechanisms.
  8. Explain the role of tumor-derived exosomes in cancer disease progression. Why can exosomes be used as diagnostic and prognostic biomarkers for disease progression?
  9. Explain the role of antigen presentation in cancer. In your response, include why it is beneficial for the cancer cell to downregulate MHC I expression, inhibit MHC II expression and block cross-presentation. what are some of the ways that tumor cells inhibit the activation of the adaptive immune system?
  10. What is adoptive dendritic cell therapy? compare and contrast the advantages and limitations of dendritic cell vaccines to adoptive T cell therapy.