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Epigenetic-based targeted therapies for well-differentiated pancreatic neuroendocrine tumors: recent advances and
Francesca Marini1,2, Francesca Giusti1, Maria Luisa Brandi2
1Department of Experimental and Clinical Biomedical Sciences, University of refereFlorence, Florence, Italy.
Introduction:
Well-differentiated pancreatic neuroendocrine tumors (PanNETs) are a heterogeneous group of primary tumors of the endocrine pancreas. Dysregulation of chromatin remodeling, gene expression alteration, global DNA hypomethylation of non-coding regions, DNA hypermethylation and silencing of tumor suppressor gene promoters are frequent epigenetic changes in PanNETs. These changes exert a role in neoplastic transformation and progression. As epigenetic mechanisms, converse to genetic mutations, are potentially reversible, they are an interesting and promising therapeutic target for the treatment of PanNETs.
Areas Covered:
We reviewed main epigenetic alterations associated with the development, biological and clinical features and progression of PanNETs, as well as emerging therapies targeting epigenetic changes, which may prove effective for the treatment of human PanNETs.
Expert Opinion:
Constant advances in the PanNET medical approach, as reported in the clinical and therapeutic recommendations of ESMO, improved the overall survival of patients over the years. However, over 60% of the patients with metastatic disease still have poor prognosis. Epigenetic regulator drugs, currently approved to treat some human malignancies, that showed anti-tumoral activity also on PanNETs, in pre-clinical and clinical studies, could concur to ameliorate the prognosis and OS of advanced and metastatic PanNET, in combination with surgery and currently employed medical therapies.
Insights
Epigenetic alterations drive pancreatic neuroendocrine tumor (PanNET) progression. Targeting these reversible epigenetic changes offers a promising therapeutic strategy for improving patient outcomes, especially in advanced disease.
Area of Science:
- Oncology
- Epigenetics
- Translational Research
Background:
- Pancreatic neuroendocrine tumors (PanNETs) are a heterogeneous group of endocrine pancreatic tumors.
- Epigenetic alterations, including DNA methylation and chromatin remodeling, are common in PanNETs and contribute to tumor development and progression.
Purpose of the Study:
- To review key epigenetic alterations in PanNETs.
- To discuss emerging therapies targeting these epigenetic changes for PanNET treatment.
Main Methods:
- Literature review of epigenetic alterations in PanNETs.
- Analysis of current therapeutic strategies and emerging epigenetic drugs.
Main Results:
- Epigenetic dysregulation plays a significant role in PanNET pathogenesis and progression.
- Epigenetic therapies have shown anti-tumoral activity in pre-clinical and clinical studies for PanNETs.
Conclusions:
- Epigenetic mechanisms are potentially reversible, making them attractive therapeutic targets for PanNETs.
- Epigenetic drugs, in combination with standard treatments, may improve prognosis and overall survival (OS) in advanced and metastatic PanNET patients.
