Werner Rachael J, Kelly Andrew D, Issa Jean-Pierre J
From the *Fels Institute for Cancer Research and Molecular Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
Cancer J. 2017 Sep/Oct;23(5):262-269. doi: 10.1097/PPO.0000000000000281.
Epigenetic alterations such as DNA methylation defects and aberrant covalent histone modifications occur within all cancers and are selected for throughout the natural history of tumor formation, with changes being detectable in early onset, progression, and ultimately recurrence and metastasis. The ascertainment and use of these marks to identify at-risk patient populations, refine diagnostic criteria, and provide prognostic and predictive factors to guide treatment decisions are of growing clinical relevance. Furthermore, the targetable nature of epigenetic modifications provides a unique opportunity to alter treatment paradigms and provide new therapeutic options for patients whose malignancies possess these aberrant epigenetic modifications, paving the way for new and personalized medicine. DNA methylation has proven to be of significant clinical utility for its stability and relative ease of testing. The intent of this review is to elaborate upon well-supported examples of epigenetic precision medicine and how the field is moving forward, primarily in the context of aberrant DNA methylation.
表观遗传改变，如DNA甲基化缺陷和异常的共价组蛋白修饰，在所有癌症中都会发生，并且在肿瘤形成的自然史中被选择出来，在早期发病、进展以及最终的复发和转移过程中都能检测到变化。确定并利用这些标记来识别高危患者群体、完善诊断标准以及提供预后和预测因素以指导治疗决策，其临床相关性日益增加。此外，表观遗传修饰的可靶向性为改变治疗模式提供了独特的机会，并为那些恶性肿瘤具有这些异常表观遗传修饰的患者提供了新的治疗选择，为新型个性化医学铺平了道路。DNA甲基化因其稳定性和相对易于检测，已被证明具有重要的临床应用价值。本综述的目的是详细阐述表观遗传精准医学的有力实例，以及该领域如何向前发展，主要是在异常DNA甲基化的背景下。
