Targeting key epigenetic regulators in solid tumors: focus on EZH2, PRMT5, and BET inhibitors

Epigenetic dysregulation is a hallmark of cancer and a promising therapeutic target in solid tumors. This review highlights key advances in targeting epigenetic regulators such as EZH2, PRMT5, and BET proteins. EZH2 inhibition has achieved the first clinical approval in SMARCB1-deficient epithelioid sarcoma, whereas PRMT5 inhibitors exploit synthetic lethality through MTAP loss, representing a biomarker-driven therapeutic strategy in solid tumors, with next-generation selective compounds showing early activity in MTAP-deleted tumors and improved tolerability. BET inhibitors, though biologically promising, currently face challenges of toxicity and limited efficacy as monotherapy but demonstrate potential in combination strategies, particularly in glioblastoma. We analyze recent advances and ongoing investigations, as well as future directions in the development of epigenetic therapies in solid tumors. Overall, epigenetic inhibitors are poised to become an expanding pillar of precision oncology, bridging chromatin biology with clinical benefit.