Role Of Epigenetic Drugs In Sensitizing Cancers To Anticancer Therapies: Emerging Trends And Clinical Advancements

Abstract

Epigenetic changes play a significant role in cancer progression, maintenance and therapy resistance. Generally, epigenetic modifications are reversible, thereby gaining attention for therapeutic interventions. However, limited efficacy and therapy resistance remain the significant limitations of conventional and epigenetic anticancer therapies. Recently, combination therapies with epigenetic drugs (epi-drugs) and conventional anticancer treatment have gained widespread attention. Here, epi-drugs are administered with anticancer therapies to increase their therapeutic efficacy and sensitize cancer cells resistant to therapies. This review summarizes the mechanism of epi-drugs in reversing resistance to anticancer therapies. Further, the challenges faced during developing combination therapies with epi-drugs are discussed. We believe the clinical benefit of combination therapies could be increased by overcoming the challenges faced during epi-drug development.

Plain language summary

Epigenetic changes play a significant role in cancer development and progression. Epigenetic drugs (epi-drugs) target enzymes involved in regulating epigenetic changes to maintain normal cell functioning. Epi-drugs include histone deacetylase inhibitors and DNA methyltransferase inhibitors, among others. These drugs have shown potential as standalone treatments for cancer and have also been found to work well in combination with other therapies (chemotherapy, radiotherapy and immunotherapy), helping to overcome treatment resistance. By targeting the epigenetic alterations that contribute to treatment resistance, epi-drugs have the potential to enhance the effectiveness of these therapies. This review article focuses on how epi-drugs overcome resistance to different cancer treatments. Combining epi-drugs with conventional anticancer therapies could provide better management of cancer. However, more preclinical and clinical research is needed to understand the potential benefits and optimize the use of these combinations fully. Overall, epi-drugs offer a promising avenue for improving cancer treatment outcomes and warrant further investigation.

Tweetable abstract

Epigenetic changes drive carcinogenesis & therapy resistance. This review explores the potential of combining epi-drugs with anticancer therapies to overcome therapy resistance and revolutionize cancer care. #Epigenetics #CancerResearch

Graphical abstract

Keywords::

• cancer epigenetics
• conventional therapies
• DNMTi
• epi-drugs
• HDACi
• therapy resistance

Collection of literature and writing the manuscript: D Singh. Review and Editing: D Singh, MA Khan, HR Siddique. Concept and supervision: HR Siddique. All authors have approved the final version of the article.

Acknowledgments

The authors thank the Department of Zoology, Aligarh Muslim University, Aligarh, India, for providing the necessary facilities. D Singh (524/ (UGC NET JUNE 2019) and MA Khan (09/112(0599)/2018-EMR-I) are thankful to the University Grants Commission and Council of Scientific and Industrial Research (CSIR), respectively, for fellowships. HR Siddique is grateful to the University Grants Commission (UGC) and Department of Science and Technology-Science and Engineering Research Board (DST-SERB), New Delhi, India, for financial support.

Financial & competing interests disclosure

This work was supported by the University Grants Commission (F.30–377/2017(BSR) and the Department of Science and Technology-Science and Engineering Research Board (EMR/20l7/001758). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

This work was supported by the University Grants Commission (F.30–377/2017(BSR) and the Department of Science and Technology-Science and Engineering Research Board (EMR/20l7/001758). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.