Impact of epigenetics on the clinical management of cancer patients

In the early 1980s, the first changes in DNA associated with a chemical change called methylation were discovered, followed by the discovery in the mid-1990s of the first tumor suppressor gene to be disabled. triggered by these modifications of the genetic material. In the early 2000s, these changes were used as a biomarker of cancer for the first time, as well as the first time drugs were used against them.

In parallel, the first chemical modifications were detected in proteins called histones, where DNA wrapped around them like a pearl necklace. The “decoration” of DNA and its regulatory proteins defines the epigenetic domain.

Now, in a journal article CA: Journal of Oncology for CliniciansDr Manel Esteller, Director of the Josep Carreras Leukemia Research Institute (IJC), ICREA Research Professor and Professor of Genetics at the University of Barcelona, ​​and researcher Dr. Verónica Dávalos explain the impact of epigenetics for the clinical management of cancer patients.

Dr. Esteller said, “Epigenetics has ceased to be a purely fundamental field of study focused on the study of how gene expression controlled as a tool to improve early detection, predict disease progression, and become a target for new treatments. One of the most prominent aspects of clinical translation is its use in liquid biopsies, as well as helping to classify tumor types, for example accurately diagnosing tumors originating from the brain, skeletal muscles, joints, and joints. , bones or of unknown origin. But beyond this aspect, DNA methylation profiling is approved to determine the therapeutic efficacy of brain tumors and other tumor pathologies.”

Perhaps one of the most intriguing aspects for oncologists is the use of epigenetic drugs for treatment. cancer. There are currently 9 drugs against different epigenetic markers (DNA methylation, methylation and histone acetylation) approved for clinical use in various types of leukemia, lymphoma, and blood diseases. , as well as tumors of soft tissue. Esteller says, “These treatments are generally very well tolerated by patients, and more than killing tumor cells, they stop its growth as if it were a domesticated animal.”

Epigenetic drugs are a clinical fact and they have benefited patients, but research must continue. Currently, there is a whole new generation of epigenetic drugs that are in various stages of clinical trials that alone or in combination with immunotherapy can make a positive difference in many patients.