Cancer is a strong focus of epigenetic research. A critical issue in oncology is that average cancer treatment isn’t producing the best outcomes for the majority of people. Drug companies trying to produce effective treatments for the average of the population, struggle with poor results in large scale clinical trials. Patients are clamoring for personalized medicine. To meet this goal, clinicians need cancer biomarkers. Through excellent research efforts, epigenomics is adding a richer temporal dimension into our view of oncogenesis.
Epigenetic regulation mechanisms act as a group of musicians playing from the composition of the genetic code. They play as a large orchestra of integrated gene networks, keeping cells on a differentiated path. Researchers have identified three main sections in nature’s epigenetic orchestra; DNA methylation, histone modifications, and the action of small non-coding RNAs. Thus, the composition of our genes is played, producing the music of gene expression.
Cancer can be thought of as a type of failure within an epigenetic orchestra. Researchers are “listening” carefully, to identify the complex, multi-layered, related processes leading to up to oncogenesis, which promote the formation of cancer stem cells. The orchestras of cancer stem cells produce the dysregulated noise of cellular growth and division. These cancer stem cells can influence their neighboring cells, metastasize, and form new tumors, promoting the problems of drug resistance, and cancer relapse.
Opportunities for successful personalized cancer treatment, lie in establishing epigenetic biomarkers paired with epigenetic therapies. Identifying and understanding biomarkers would help oncologists predict the risk to the orchestral players of the epigenetic process dynamically. The best epigenetic therapy would then ideally act as a highly specific conductor, modulating the epigenetic orchestra to the musical piece of cellular life, and appropriate cellular death. There are multiple goals of personalized oncology which epigenetic biomarkers have a role in. For example:
• Providing clinicians the tumor expression profile diagnostic tests to accurately identify responders before chemotherapy treatment.
• Diagnostic tests to identify drug resistance.
• Providing therapeutic options through the development of targeted epigenetic drugs, to combine with radiation and other chemotherapies.
• Cancer prevention and early detection. Development of epigenetic profiling to predict individual risk in real time, to approaching environmental carcinogen exposure thresholds.
• Creation of new personalized treatment guidelines.
How does your area of research contribute to a practical clinical application in cancer diagnosis, risk or treatment?