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Updated: Nov 22, 2025

Repressing Gene Transcription by Redirecting Cellular Machinery with Chemical Epigenetic Modifiers
Published on: September 20, 2018
Targeting epigenetic regulatory machinery to overcome cancer therapy resistance
Lei Guo1, Yi-Tsang Lee2, Yubin Zhou3
1Center for Epigenetics & Disease Prevention, Institute of Biosciences and Technology, Texas A&M University, Houston, TX, 77030, USA; Center for Translational Cancer Research, Institute of Biosciences and Technology, Texas A&M University, Houston, TX, 77030, USA.
Abstract:
Drug resistance, either intrinsic or acquired, represents a major hurdle to achieving optimal therapeutic outcomes during cancer treatment. In addition to acquisition of resistance-conferring genetic mutations, accumulating evidence suggests an intimate involvement of the epigenetic machinery in this process as well. Recent studies have revealed that epigenetic reprogramming, such as altered expression or relocation of DNA/histone modulators accompanied with chromatin structure remodeling, can lead to transcriptional plasticity in tumor cells, thereby driving their transformation towards a persistent state. These "persisters" represent a pool of slow-growing cells that can either re-expand when treatment is discontinued or acquire permanent resistance. Targeting epigenetic reprogramming or plasticity represents a new strategy to prevent the emergence of drug-refractory populations and to enable more consistent clinical responses. With the growing numbers of drugs or drug candidates developed to target epigenetic regulators, more and more epigenetic therapies are under preclinical evaluation, early clinical trials or approved by FDA as single agent or in combination with existing antitumor drugs. In this review, we highlight latest discoveries in the mechanistic understanding of epigenetically-induced drug resistance. In parallel, we discuss the potential of combining epigenetic drugs with existing anticancer regimens as a promising strategy for overcoming cancer drug resistance.
Insights
Epigenetic reprogramming drives cancer drug resistance by creating persistent cells. Targeting these epigenetic changes offers a new strategy to improve cancer treatment outcomes and overcome resistance.
Area of Science:
- Oncology
- Epigenetics
- Cancer Biology
Background:
- Drug resistance is a significant challenge in cancer therapy.
- Epigenetic alterations, not just genetic mutations, contribute to acquired or intrinsic drug resistance.
- Epigenetic reprogramming drives tumor cell plasticity, leading to drug-tolerant persister cells.
Purpose of the Study:
- To review the latest discoveries in the mechanisms of epigenetically-induced drug resistance.
- To discuss the potential of epigenetic therapies in overcoming cancer drug resistance.
- To highlight the role of epigenetic reprogramming and plasticity in cancer treatment failure.
Main Methods:
- Review of recent scientific literature on epigenetics and cancer drug resistance.
- Analysis of studies investigating epigenetic modulators and chromatin remodeling in cancer cells.
- Examination of preclinical and clinical data on epigenetic drugs and combination therapies.
Main Results:
- Epigenetic reprogramming alters gene expression and chromatin structure, promoting a persistent, drug-tolerant state in cancer cells.
- These epigenetic changes enable tumor cells to evade current therapies and lead to treatment failure.
- Emerging epigenetic drugs show promise in preclinical and clinical settings for overcoming resistance.
Conclusions:
- Targeting epigenetic reprogramming and plasticity is a promising strategy to prevent drug resistance.
- Combination therapies involving epigenetic drugs and existing anticancer agents may enhance treatment efficacy.
- Further research into epigenetic mechanisms is crucial for developing novel cancer therapies.
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