Among the most significant discoveries from cancer genomics efforts has been the critical role of epigenetic dysregulation in cancer development and progression. Studies across diverse cancer types have revealed frequent mutations in genes encoding epigenetic regulators, alterations in DNA methylation and histone modifications, and a dramatic reorganization of chromatin structure. Epigenetic changes are especially relevant to pediatric cancers, which are often characterized by a low rate of genetic mutations. The inherent reversibility of epigenetic lesions has led to an intense interest in the development of epigenetic targeted therapies. Additionally, the recent appreciation of the interplay between the epigenome and immune regulation has sparked interest in combination therapies and synergistic immunotherapy approaches. Further, the recent appreciation of epigenetic variability as a driving force in cancer evolution has suggested new roles for epigenetic therapies in limiting plasticity and resistance. Here, we review recent progress and emerging directions in the development of epigenetic targeted therapeutics and their promise across the landscape of childhood cancers.
在癌症基因组学研究中最重要的发现之一是表观遗传失调在癌症发生和发展中的关键作用。针对多种癌症类型的研究揭示了编码表观遗传调控因子的基因频繁突变、DNA甲基化和组蛋白修饰的改变,以及染色质结构的显著重组。表观遗传变化尤其与儿童癌症相关,这类癌症通常以基因突变率低为特征。表观遗传损伤固有的可逆性引发了人们对开发表观遗传靶向疗法的浓厚兴趣。此外,近期对表观基因组与免疫调控之间相互作用的认识,激发了人们对联合疗法和协同免疫治疗方法的兴趣。进一步地,最近认识到表观遗传变异是癌症进化的驱动力,这提示了表观遗传疗法在限制肿瘤可塑性和耐药性方面的新作用。本文综述了表观遗传靶向治疗开发的最新进展和新兴方向,及其在儿童癌症治疗领域的应用前景。
Progress Toward Epigenetic Targeted Therapies for Childhood Cancer