Monoclonal antibodies, the shining star in the anti-cancer therapeutics firmament, are faced with some new competition. While epigenetic therapeutics have been around for a while, a raft of new clinical trials are in progress, and with any luck the next few years will see a number of FDA approvals for these agents.
As was pointed out at recent symposium (Third World Epigenetics Summit, Boston, July 24-26), epigenetic drugs offer a number of important advantages over other forms of cancer treatment. First of all, their mechanism of action is well understood, as they target a specific enzyme in the oncogenic process. Secondly, they are small molecules, which means they can be taken orally, saving the patient discomfort, cost and inconvenience.
Thirdly, there are already FDA-approved epigenetic anti-cancer drugs available, such as azacytidine, and trials can combine an approved drug with one of the compounds under evaluation. And finally, epigenetic drugs, unlike traditional antimitotic agents, are specific in their targeting. Rather than blasting away, machine gun style, at the objective, they aim at a very specific reaction site within the cell. So far their side effects have proven to be relatively minor.
The last century of the war on cancer certainly serves as a powerful admonition against irrational exuberance, but at this stage there is certainly reason for positive beliefs, and the coming trials will be closely followed.
Our report on Epigenetics is available from Kalorama Information at our website.