A New Direction in the Fight Against Cancer—Epigenetic Therapy Could Improve Relapse Rates

Epigenetics, the pattern of how genes are turned “on” and “off,” could play a larger role in cancer than previously thought. A new review article explores data that support the role of epigenetic mechanisms in how cancers develop resistance to chemotherapy and recur even after successful treatment.

Meghan Leary

The review, whose first author is BUSM fourth-year student Meghan Leary, argues that there may be a role for drugs that target cancer cells’ epigenetic mechanisms in addition to conventional chemotherapy. The researchers propose that changes in normal epigenetic regulation might be an underlying factor in cancer cells’ harmful behaviors. “Treatment with epigenetic drugs can reverse the predisposition to tumor growth and metastasis as well as stop the formation of cancer stem cells and make drug resistant cancer cells susceptible,” Ms. Leary explained. As a result, adding epigenetic treatments alongside chemotherapy might reduce rates of treatment failure and recurrence of cancer after treatment.

In addition to improving cancer treatment in general, epigenetic therapies have the potential to be targeted to each individual. “The concept of a new paradigm of cancer treatment that focuses on the underlying epigenetic alterations that predispose us to cancer as well as to drug resistance opens new avenues in personalized medicine and bioinformatics,” said Ms. Leary. “The individualized alterations in our genetic expression could be modeled to predict the success of various drug treatments.”

Despite being a promising line of research for the future, epigenetic treatments in cancer are still at an early stage. There is a great deal about epigenetics that is not well understood and the authors caution that there is the potential for unwanted effects by manipulating such a complex system. Even so, these targets may be the key to more effective cancer treatments in the future.

The review was published in the journal Cancers.

Submitted by Benjamin Trachtman, MD