The Epigenetic Landscape in the Treatment of Gynecologic Malignancies

Am Soc Clin Oncol Educ Book. 2018 May 23:38:480-487. doi: 10.1200/EDBK_200203.

Abstract

The care of patients with advanced-stage or recurrent endometrial, ovarian, and cervical cancer remains clinically challenging. Despite the identification of novel therapeutics and advancements in supportive care, survival outcomes have been relatively unchanged over the past decade. In addition to established genomic alterations and the contributions of the tumor microenvironment to cancer progression, epigenetic mechanisms have emerged as important contributors to gynecologic cancer progression. DNA methylation, histone modification, and noncoding RNA expression may be important contributors to disease initiation and progression and may represent novel therapeutic targets. This article reviews the epigenetic landscape of endometrial, ovarian, and cervical cancer, describing the state of the science and discussing potential clinical applications. To date, the role of epigenetic drugs in the treatment of gynecologic cancers remains unclear, although continued progress may inform future treatment modalities.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers
  • Clinical Trials as Topic
  • DNA Methylation / drug effects
  • Endometrial Neoplasms / drug therapy
  • Endometrial Neoplasms / genetics
  • Endometrial Neoplasms / pathology
  • Epigenesis, Genetic* / drug effects
  • Female
  • Gene Expression Regulation, Neoplastic / drug effects
  • Genital Neoplasms, Female / drug therapy*
  • Genital Neoplasms, Female / genetics*
  • Genital Neoplasms, Female / mortality
  • Genital Neoplasms, Female / pathology
  • Humans
  • Molecular Targeted Therapy
  • Mutation
  • Ovarian Neoplasms / drug therapy
  • Ovarian Neoplasms / genetics
  • Ovarian Neoplasms / pathology
  • Promoter Regions, Genetic
  • Treatment Outcome
  • Uterine Cervical Neoplasms / drug therapy
  • Uterine Cervical Neoplasms / genetics
  • Uterine Cervical Neoplasms / pathology

Substances

  • Antineoplastic Agents
  • Biomarkers