Immunotherapy for Cancer: A Comprehensive Guide for Medical Students

Question 1

Immunotherapy, a rapidly advancing cancer treatment, poses ethical and societal implications. Examine these implications, considering potential side effects, long-term consequences, and equitable access.

Accepted Answer

Immunotherapy raises ethical concerns about potential side effects, long-term consequences, and equitable access.

Answer

Immunotherapy is ethically sound, with no long-term concerns or equity issues.

Answer

Immunotherapy's high cost is not an ethical concern if it's effective.

Answer

Immunotherapy's long-term effects on future generations are known and raise no ethical concerns.

Question 2

Which of the following is a primary class of immunotherapy used for cancer treatment?

Accepted Answer

Monoclonal antibodies

Answer

Chemotherapy

Answer

Radiation therapy

Answer

Surgery

Question 3

What is the fundamental mechanism of action of immune checkpoint inhibitors?

Accepted Answer

Blocking the interactions of inhibitory molecules with T cells

Answer

Stimulating the expansion of T cells

Answer

Inducing apoptosis in cancer cells

Answer

Promoting antibody production

Question 4

Which of the following illustrates an example of adoptive cell therapy?

Accepted Answer

CAR T-cell therapy

Answer

PD-1 inhibitors

Answer

Bispecific antibodies

Answer

Immune checkpoint inhibitors

Question 5

What is the primary mechanism of resistance to PD-1 inhibitors?

Accepted Answer

Increased expression of PD-L1

Answer

Loss of MHC-I expression

Answer

Elevated production of TGF-beta

Answer

Mutations in the PD-1 receptor

Question 6

What is a primary benefit of monoclonal antibody therapy compared to chemotherapy?

Accepted Answer

Higher specificity and fewer side effects

Answer

Reduced side effects only

Answer

Enhanced efficacy only

Answer

Lower cost only

Question 7

What is the primary goal of cancer immunotherapy?

Accepted Answer

To induce a durable anti-tumor immune response

Answer

To cure all cancer patients

Answer

To reduce tumor size and alleviate symptoms

Answer

To prevent metastasis

Question 8

Which of the following is a potential side effect of immunotherapy?

Accepted Answer

Immune-related adverse events (irAEs)

Answer

Myelosuppression

Answer

Cardiotoxicity

Answer

Nephrotoxicity

Question 9

What is the mechanism of action of CAR T-cell therapy?

Accepted Answer

Genetic modification of T cells to express chimeric antigen receptors (CARs) specific to tumor antigens

Answer

Administration of high-dose chemotherapy to eliminate immunosuppressive cells

Answer

Use of monoclonal antibodies to block immune checkpoints

Answer

Isolation and expansion of tumor-specific T cells from the patient's own immune system

Question 10

What is the role of dendritic cells in cancer immunotherapy?

Accepted Answer

Presenting tumor antigens to T cells and initiating an immune response

Answer

Producing cytokines that stimulate T cell proliferation and activation

Answer

Suppressing immune responses to prevent autoimmunity

Answer

Eliminating tumor cells directly

Question 11

Describe the mechanisms by which immune checkpoint inhibitors modulate T cell activity.

Accepted Answer

Immune checkpoint inhibitors enhance T cell proliferation and cytokine production by releasing the brakes on T cell responses.

Answer

Immune checkpoint inhibitors directly activate T cells by binding to co-stimulatory receptors.

Answer

Immune checkpoint inhibitors enhance T cell proliferation and cytokine production by releasing inhibitory signals.

Answer

Immune checkpoint inhibitors promote T cell differentiation into regulatory T cells, suppressing immune responses.

Question 12

What is the primary function of immune checkpoint inhibitors in cancer immunotherapy?

Accepted Answer

Blocking inhibitory signals on immune cells, allowing them to recognize and attack tumor cells more effectively

Answer

Stimulating the production of cytotoxic cytokines, directly killing tumor cells

Answer

Increasing tumor cell antigen presentation, making them more recognizable to the immune system

Answer

Enhancing the recruitment of immune effector cells to the tumor microenvironment

Question 13

Which of the following cell types plays a critical role in mediating innate immune responses in cancer immunotherapy?

Accepted Answer

Natural killer (NK) cells

Answer

Dendritic cells

Answer

Macrophages

Answer

Neutrophils

Question 14

What is the term for the ability of the immune system to recognize and respond to specific antigens in a specific and targeted manner?

Accepted Answer

Specificity

Answer

Antigenicity

Answer

Immunogenicity

Answer

Affinity

Question 15

In cancer treatment, what are the clinical applications of CAR T-cell therapy? Critically assess its benefits, drawbacks, and potential future directions.

Accepted Answer

Long-lasting remissions in specific cancers

Accepted Answer

Limited by T-cell exhaustion

Answer

Low risk of cytokine release syndrome

Answer

Effective against a wide range of cancers

Question 16

Which of the following best describes the underlying principle of immunotherapy in cancer treatment?

Accepted Answer

Stimulating the body's own immune system to combat cancer cells

Answer

Directly killing cancer cells with cytotoxic agents

Answer

Preventing the growth of new blood vessels that supply tumors

Answer

Suppressing the immune system to prevent excessive inflammation

Question 17

Monoclonal antibodies in immunotherapy are primarily designed to:

Accepted Answer

Target and eliminate specific cancer cells

Answer

Enhance the immune response against cancer

Answer

Block the growth of blood vessels feeding tumors

Answer

Stimulate the production of anti-cancer antibodies by the immune system

Question 18

Which type of adoptive cell therapy involves genetically modifying a patient's own immune cells to recognize and attack cancer?

Accepted Answer

Chimeric antigen receptor (CAR) T-cell therapy

Answer

Natural killer (NK) cell therapy

Answer

Tumor-infiltrating lymphocyte (TIL) therapy

Answer

Dendritic cell therapy

Question 19

The primary mechanism of immune checkpoint inhibitors in immunotherapy is:

Accepted Answer

Blocking inhibitory signals on T cells to unleash their anti-cancer activity

Answer

Suppressing the immune system to prevent excessive inflammation

Answer

Directing immune cells to target specific cancer cells

Answer

Stimulating the production of antibodies that bind to cancer cells

Question 20

In the United States, which organization is primarily responsible for regulating the development and approval of immunotherapy products?

Accepted Answer

Food and Drug Administration (FDA)

Answer

National Cancer Institute (NCI)

Answer

Centers for Medicare & Medicaid Services (CMS)

Answer

American Society of Clinical Oncology (ASCO)

Question 21

Which of the following monoclonal antibodies is used to treat HER2-positive breast cancer?

Accepted Answer

Trastuzumab

Answer

Rituximab

Answer

Alemtuzumab

Answer

Ipilimumab

Question 22

Which type of adoptive cell therapy involves genetically engineering a patient's T cells to express a chimeric antigen receptor (CAR) that recognizes cancer cells?

Accepted Answer

Chimeric antigen receptor (CAR) T-cell therapy

Answer

Tumor-infiltrating lymphocytes (TILs)

Answer

Dendritic cell therapy

Answer

Natural killer (NK) cell therapy

Question 23

What is the primary mechanism of action of immune checkpoint inhibitors?

Accepted Answer

Blocking inhibitory signals on T cells, releasing their anti-tumor activity.

Answer

Activating inhibitory signals on cancer cells, making them less susceptible to immune attack.

Answer

Stimulating the production of new T cells and NK cells.

Answer

Directly killing cancer cells.

Question 24

The following are types of monoclonal antibody therapies EXCEPT:

Accepted Answer

Polyclonal antibody therapy

Answer

Fab fragment therapy

Answer

Chimeric antibody therapy

Answer

Humanized antibody therapy

Question 25

Adoptive cell therapy involves modifying which cell type for enhanced anti-tumor activity?

Accepted Answer

T cell

Answer

Macrophage

Answer

B cell

Answer

Dendritic cell

Question 26

Autoimmune reactions are a potential adverse effect associated with which immunotherapy approach?

Accepted Answer

Immune checkpoint inhibitor therapy

Answer

Nephrotoxicity

Answer

Myelosuppression

Question 27

Which type of immunotherapy stimulates the immune system's innate response?

Accepted Answer

Toll-like receptor agonists

Answer

Immune checkpoint inhibitors

Answer

Adoptive cell therapy

Question 28

A defining feature of CAR T-cell therapy is:

Accepted Answer

Engineered T cells expressing a chimeric antigen receptor

Answer

Use of unmodified T cells

Answer

Targeting of non-specific tumor antigens

Question 29

A limitation of immunotherapy is that it:

Accepted Answer

Can be ineffective against certain types of cancer

Answer

Can be used for any cancer stage

Answer

Has no side effects

Answer

Always cures cancer

Question 30

Precision medicine in immunotherapy involves:

Accepted Answer

Tailoring treatment based on genetic and molecular profiles

Answer

Treating all patients with the same immunotherapy regimen

Answer

Ignoring the immune status of patients

Question 31

Adoptive cell therapy involves the transfer of __________ cells.

Accepted Answer

Genetically engineered T cells or natural killer cells

Answer

Dendritic cells

Answer

Macrophages

Answer

B cells

Question 32

Which of the following is **not** an immune checkpoint inhibitor?

Accepted Answer

Trastuzumab

Answer

Nivolumab

Answer

Pembrolizumab

Answer

Ipilimumab

Question 33

Which cytokine is primarily responsible for stimulating the activation and proliferation of cytotoxic T cells in immunotherapy?

Accepted Answer

Interleukin-2

Answer

Tumor necrosis factor-alpha

Answer

Interleukin-10

Answer

Interferon-gamma

Question 34

Which type of immune cell is primarily targeted by CAR T cell therapy?

Accepted Answer

T cells

Answer

Macrophages

Answer

B cells

Answer

Dendritic cells

Question 35

What is the primary goal of neoadjuvant immunotherapy in cancer treatment?

Accepted Answer

To shrink the tumor prior to surgery, improving resectability and potentially increasing the chances of a complete resection.

Answer

To enhance the efficacy of radiation therapy

Answer

To stimulate the adaptive immune response

Answer

To prevent metastasis

Question 36

What is the mechanism of action of oncolytic viruses in cancer immunotherapy?

Accepted Answer

Selective replication within cancer cells leading to cell death and the release of tumor-specific antigens

Answer

Blocking of growth factor signaling

Answer

Activation of cytotoxic T cells

Question 37

Which type of cancer is generally considered to be most responsive to immunotherapy?

Accepted Answer

Melanoma

Answer

Breast cancer

Answer

Lung cancer

Answer

Colon cancer

Question 38

What is the primary advantage of using combination immunotherapy regimens?

Accepted Answer

Overcoming tumor heterogeneity and resistance mechanisms, thereby improving treatment efficacy

Answer

Improving overall survival

Answer

Simplifying treatment administration

Answer

Reducing the risk of adverse effects

Question 39

Which of the following is NOT a primary type of immunotherapy used for cancer treatment?

Accepted Answer

Antibiotics

Answer

Immune checkpoint inhibitors

Answer

Monoclonal antibodies

Answer

Adoptive cell therapy

Question 40

What is the main mechanism by which monoclonal antibodies exert their anti-cancer effects?

Accepted Answer

Bind to specific antigens on cancer cells, marking them for destruction

Answer

Inhibit immune checkpoint molecules, unleashing the immune response

Answer

Stimulate the immune system to attack cancer cells

Answer

Kill cancer cells directly

Question 41

What is the fundamental purpose of immune checkpoint inhibitors in immunotherapy?

Accepted Answer

To remove inhibitory signals on immune cells, allowing them to effectively target cancer cells

Answer

To directly destroy cancer cells

Answer

To stimulate the production of new immune cells

Answer

To suppress excessive immune responses to prevent autoimmunity

Question 42

Which of the following is a potential advantage of immunotherapy compared to traditional cancer treatments?

Accepted Answer

Increased tumor specificity and reduced systemic toxicity

Answer

Lower treatment costs

Answer

Fewer hospital visits

Answer

Faster tumor regression

Question 43

Which of the following best describes the primary mechanism of action of monoclonal antibodies used in cancer immunotherapy?

Accepted Answer

Binding to specific antigens on cancer cells and triggering their elimination

Answer

Inhibiting the angiogenesis process in tumors

Answer

Blocking the growth factor receptors on cancer cells

Question 44

Which type of adoptive cell therapy involves genetically modifying a patient's own T cells to express a chimeric antigen receptor (CAR) specific for a tumor antigen?

Accepted Answer

CAR T-cell therapy

Answer

Tumor-infiltrating lymphocyte (TIL) therapy

Answer

Dendritic cell vaccination

Answer

Natural killer (NK) cell therapy

Question 45

Which of the following is a potential adverse event associated with cancer immunotherapy?

Accepted Answer

Immune-related adverse events (irAEs)

Answer

High cost

Answer

Low efficacy in certain cancer types

Answer

Requirement for specialized infrastructure

Question 46

Which of the following factors can affect the effectiveness of cancer immunotherapy?

Accepted Answer

Tumor mutational burden (TMB)

Answer

Race of the patient

Answer

Age of the patient

Answer

Gender of the patient

Question 47

Which type of immunotherapy aims to harness the innate immune system by activating natural killer (NK) cells?

Accepted Answer

NK cell-based immunotherapy

Answer

Immune checkpoint inhibition

Answer

Antibody-based immunotherapy

Answer

T cell-based immunotherapy

Question 48

Which of the following is an advantage of adoptive cell therapy over other immunotherapy approaches?

Accepted Answer

Ability to provide durable anti-tumor effects

Answer

Lower cost

Answer

Greater tumor specificity

Answer

Fewer side effects

Question 49

Which immune cells are primarily responsible for the anti-tumor activity of immune checkpoint inhibitors?

Accepted Answer

T cells

Answer

Dendritic cells

Answer

B cells

Answer

Natural killer cells

Question 50

Which strategy could potentially overcome resistance to cancer immunotherapy?

Accepted Answer

Utilizing combination therapies involving multiple immunotherapy agents

Answer

Switching to a different type of immunotherapy alone

Answer

Increasing the dosage of a single immunotherapy agent