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Cellular Epigenetic Targets and Epidrugs in Breast Cancer Therapy: Mechanisms, Challenges, and Future Perspectives
Ibrahim S Alalhareth1, Saleh M Alyami1, Ali H Alshareef2
1College of Pharmacy, Najran University, Najran 66256, Saudi Arabia.
Abstract:
Breast cancer is the most common malignancy affecting women, manifesting as a heterogeneous disease with diverse molecular characteristics and clinical presentations. Recent studies have elucidated the role of epigenetic modifications in the pathogenesis of breast cancer, including drug resistance and efflux characteristics, offering potential new diagnostic and prognostic markers, treatment efficacy predictors, and therapeutic agents. Key modifications include DNA cytosine methylation and the covalent modification of histone proteins. Unlike genetic mutations, reprogramming the epigenetic landscape of the cancer epigenome is a promising targeted therapy for the treatment and reversal of drug resistance. Epidrugs, which target DNA methylation and histone modifications, can provide novel options for the treatment of breast cancer by reversing the acquired resistance to treatment. Currently, the most promising approach involves combination therapies consisting of epidrugs with immune checkpoint inhibitors. This review examines the aberrant epigenetic regulation of breast cancer initiation and progression, focusing on modifications related to estrogen signaling, drug resistance, cancer progression, and the epithelial-mesenchymal transition (EMT). It examines existing epigenetic drugs for treating breast cancer, including agents that modify DNA, inhibitors of histone acetyltransferases, histone deacetylases, histone methyltransferases, and histone demethyltransferases. It also delves into ongoing studies on combining epidrugs with other therapies and addresses the upcoming obstacles in this field.
Insights
Epigenetic modifications play a crucial role in breast cancer development and drug resistance. Reprogramming the epigenome with epidrugs offers a promising therapeutic strategy, especially in combination with immune checkpoint inhibitors.
Area of Science:
- Oncology
- Epigenetics
- Molecular Biology
Background:
- Breast cancer is a heterogeneous malignancy influenced by diverse molecular characteristics.
- Epigenetic modifications, including DNA methylation and histone alterations, are increasingly recognized in breast cancer pathogenesis, impacting drug resistance and progression.
- These modifications offer potential as diagnostic/prognostic markers and therapeutic targets.
Purpose of the Study:
- To review the role of aberrant epigenetic regulation in breast cancer initiation and progression.
- To examine existing and emerging epidrugs for breast cancer treatment.
- To explore combination therapies involving epidrugs.
Main Methods:
- Literature review focusing on epigenetic modifications in breast cancer.
- Analysis of studies on DNA methylation and histone modifications (acetylation, methylation, demethylation).
- Examination of epidrugs targeting these modifications and their clinical applications.
Main Results:
- Epigenetic reprogramming is a viable strategy to overcome drug resistance in breast cancer.
- Epidrugs targeting DNA methylation and histone modifications show therapeutic potential.
- Combination therapies, particularly epidrugs with immune checkpoint inhibitors, are highly promising.
Conclusions:
- Aberrant epigenetic regulation is central to breast cancer progression and drug resistance.
- Epidrugs represent a novel therapeutic avenue for breast cancer, with combination therapies showing significant promise.
- Further research is needed to overcome obstacles in the clinical application of epidrugs.
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