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Published on: July 25, 2020
Targeted Epigenetic Interventions in Cancer with an Emphasis on Pediatric Malignancies
1Department of Pediatric Hematology-Oncology, Institute of Pediatrics, University of Debrecen, 4032 Debrecen, Hungary.
Abstract:
Over the past two decades, novel hallmarks of cancer have been described, including the altered epigenetic landscape of malignant diseases. In addition to the methylation and hyd-roxymethylation of DNA, numerous novel forms of histone modifications and nucleosome remodeling have been discovered, giving rise to a wide variety of targeted therapeutic interventions. DNA hypomethylating drugs, histone deacetylase inhibitors and agents targeting histone methylation machinery are of distinguished clinical significance. The major focus of this review is placed on targeted epigenetic interventions in the most common pediatric malignancies, including acute leukemias, brain and kidney tumors, neuroblastoma and soft tissue sarcomas. Upcoming novel challenges include specificity and potential undesirable side effects. Different epigenetic patterns of pediatric and adult cancers should be noted. Biological significance of epigenetic alterations highly depends on the tissue microenvironment and widespread interactions. An individualized treatment approach requires detailed genetic, epigenetic and metabolomic evaluation of cancer. Advances in molecular technologies and clinical translation may contribute to the development of novel pediatric anticancer treatment strategies, aiming for improved survival and better patient quality of life.
Insights
Epigenetic alterations are key in pediatric cancers. Targeted therapies show promise but require personalized approaches to improve outcomes and quality of life for young patients.
Area of Science:
- Oncology
- Epigenetics
- Molecular Biology
Background:
- Cancer hallmarks include epigenetic alterations like DNA methylation and histone modifications.
- These epigenetic changes offer targets for novel therapeutic interventions.
- Targeted epigenetic therapies are clinically significant in cancer treatment.
Purpose of the Study:
- To review targeted epigenetic interventions in common pediatric malignancies.
- To highlight challenges and future directions in pediatric epigenetic cancer therapy.
- To emphasize the importance of individualized treatment strategies.
Main Methods:
- Literature review of targeted epigenetic interventions.
- Focus on pediatric cancers: leukemias, brain tumors, neuroblastoma, sarcomas.
- Analysis of epigenetic patterns in pediatric versus adult cancers.
Main Results:
- DNA hypomethylating drugs, HDAC inhibitors, and histone methylation agents are clinically relevant.
- Epigenetic alterations vary between pediatric and adult cancers.
- Tissue microenvironment and interactions influence epigenetic alterations' significance.
Conclusions:
- Targeted epigenetic therapies are crucial for pediatric malignancies.
- Specificity and side effects remain challenges for current epigenetic drugs.
- Personalized genetic, epigenetic, and metabolomic evaluation is essential for effective pediatric cancer treatment.
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