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Bromodomain and extraterminal (BET) proteins: biological functions, diseases, and targeted therapy
Zhi-Qiang Wang1, Zhao-Cong Zhang1, Yu-Yang Wu2
1Department of Gynecology Oncology, Harbin Medical University Cancer Hospital, Harbin, 150086, China.
Abstract:
BET proteins, which influence gene expression and contribute to the development of cancer, are epigenetic interpreters. Thus, BET inhibitors represent a novel form of epigenetic anticancer treatment. Although preliminary clinical trials have shown the anticancer potential of BET inhibitors, it appears that these drugs have limited effectiveness when used alone. Therefore, given the limited monotherapeutic activity of BET inhibitors, their use in combination with other drugs warrants attention, including the meaningful variations in pharmacodynamic activity among chosen drug combinations. In this paper, we review the function of BET proteins, the preclinical justification for BET protein targeting in cancer, recent advances in small-molecule BET inhibitors, and preliminary clinical trial findings. We elucidate BET inhibitor resistance mechanisms, shed light on the associated adverse events, investigate the potential of combining these inhibitors with diverse therapeutic agents, present a comprehensive compilation of synergistic treatments involving BET inhibitors, and provide an outlook on their future prospects as potent antitumor agents. We conclude by suggesting that combining BET inhibitors with other anticancer drugs and innovative next-generation agents holds great potential for advancing the effective targeting of BET proteins as a promising anticancer strategy.
Insights
BET inhibitors show promise as epigenetic anticancer treatments, but limited effectiveness alone. Combining BET inhibitors with other drugs offers a promising strategy for enhanced cancer therapy.
Area of Science:
- Oncology
- Epigenetics
- Pharmacology
Background:
- BET proteins function as epigenetic interpreters, regulating gene expression crucial in cancer development.
- BET inhibitors represent a novel epigenetic approach to cancer treatment.
- Preliminary clinical trials indicate anticancer potential but limited monotherapeutic efficacy.
Purpose of the Study:
- To review the function of BET proteins and their targeting in cancer.
- To examine advances in small-molecule BET inhibitors and clinical findings.
- To explore combination strategies and resistance mechanisms for BET inhibitors.
Main Methods:
- Literature review of BET protein function, cancer targeting, and inhibitor development.
- Analysis of preclinical data and preliminary clinical trial results.
- Investigation into resistance mechanisms, adverse events, and synergistic drug combinations.
Main Results:
- BET inhibitors demonstrate anticancer potential but face challenges with monotherapy.
- Understanding resistance mechanisms and adverse events is critical for effective use.
- Numerous synergistic combinations with other agents are being explored.
Conclusions:
- Combining BET inhibitors with other anticancer drugs and next-generation agents holds significant potential.
- Optimizing combination therapies is key to advancing BET protein targeting in oncology.
- BET inhibitors are a promising strategy for potent antitumor effects when used judiciously.
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