Clinical utility of solid tumor epigenetics

Abstract The majority of solid tumors harbor disrupted epigenomes that contribute to malignancy. Over the past decade, there has been a substantial increase in our understanding of the epigenetic mechanisms underlying normal and disease states. Profiling of tumors revealed recurrent mutations in key components of the epigenetic machinery and metabolic enzymes that lead to an altered epigenetic state and oncogenic transformation. Unlike genetic events, epigenetic alterations can be targeted pharmacologically and potentially reversed. Drug discovery efforts are focused on developing epigenetic drugs and treatment regimens. Recently, altered DNA methylation has emerged as an important and promising feature for tumor classification. In this chapter, we highlight recent advances in solid tumor epigenetics, specifically focusing on epigenetic therapies and the most promising combination strategies currently under investigation. In addition, we illustrate the utility of epigenetic markers for solid tumor classification and the emerging field of analyzing epigenetic biomarkers in liquid biopsies.