Histone Methylation and Chromatin Remodeling in Non-Small Cell Lung Cancer: Mechanisms of Oncogenesis and Emerging
A Josephine Thrasher1, Omar Bushara1,2, Amy Gladstein2
1Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Abstract:
Lung cancer remains the leading cause of cancer-related death, and, despite significant advancements in targeted therapy and immunotherapy, survival for patients with advanced non-small cell lung cancer (NSCLC) remains poor. An emerging area of interest is the role of epigenetic modifiers in both the pathogenesis and treatment of NSCLC. Herein, we review a selected group of chromatin-modifying genes implicated in NSCLC, organized by their function as writers (KMT2A, SETD2, and EZH2), erasers (the KDM2, KDM5, and KDM6 demethylase families), and readers (the SWI/SNF subunits SMARCA4 and ARID1A). Writers deposit activating or repressive marks on histones to regulate gene transcription, erasers remove these marks, and readers reposition nucleosomes and control DNA accessibility. Dysregulation of these genes has been associated with tumor proliferation, metastasis, treatment resistance, and altered response to immune checkpoint blockade in NSCLC. Research within this topic is emerging, and these genes represent promising potential therapeutic avenues as well as potential biomarkers. Finally, we review the clinical trials involving targeting these genes available in the current literature. The number of NSCLC-specific trials remains limited, with the most active development in SMARCA2 inhibitors for SMARCA4-mutated tumors and EZH2 inhibitors given in tandem with PD-1 blockade. We hope this review is hypothesis-generating for ongoing investigation into the role of epigenetic modifiers in NSCLC and their potential to expand the therapeutic armamentarium available for this disease.
Insights
Epigenetic modifiers play a key role in non-small cell lung cancer (NSCLC) development and treatment. Targeting these chromatin-modifying genes offers promising therapeutic strategies and potential biomarkers for NSCLC.
Area of Science:
- Oncology
- Epigenetics
- Molecular Biology
Background:
- Non-small cell lung cancer (NSCLC) remains a leading cause of cancer mortality, with poor survival rates for advanced stages despite current therapies.
- Epigenetic modifiers, including chromatin-modifying genes, are increasingly recognized for their roles in NSCLC pathogenesis and therapeutic response.
- Understanding these epigenetic alterations is crucial for developing novel treatment strategies.
Purpose of the Study:
- To review key chromatin-modifying genes (writers, erasers, readers) implicated in non-small cell lung cancer (NSCLC).
- To discuss the association of dysregulated epigenetic modifiers with NSCLC progression, metastasis, and treatment resistance.
- To explore the potential of targeting epigenetic modifiers as therapeutic strategies and biomarkers for NSCLC.
Main Methods:
- Literature review of chromatin-modifying genes (writers: KMT2A, SETD2, EZH2; erasers: KDM2, KDM5, KDM6 families; readers: SMARCA4, ARID1A) in NSCLC.
- Analysis of the functional roles of these epigenetic modifiers in gene transcription, DNA accessibility, and tumor biology.
- Survey of current clinical trials targeting epigenetic modifiers in NSCLC.
Main Results:
- Dysregulation of writers, erasers, and readers is linked to NSCLC proliferation, metastasis, and resistance to therapies, including immunotherapy.
- Emerging research highlights these genes as promising therapeutic targets and potential biomarkers for NSCLC.
- Clinical trials are limited but show active development for SMARCA2 inhibitors in SMARCA4-mutated NSCLC and EZH2 inhibitors combined with PD-1 blockade.
Conclusions:
- Epigenetic modifiers represent a critical area for NSCLC research, offering novel therapeutic avenues.
- Targeting these genes may expand the treatment options for patients with advanced NSCLC.
- Further investigation is warranted to fully elucidate their role and clinical utility in NSCLC management.
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