Small-molecule inhibitors of epigenetic mutations as compelling drug-targets for myelodysplastic syndromes.

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Small-molecule inhibitors of epigenetic mutations as compelling drug-targets for myelodysplastic syndromes.

Curr Cancer Drug Targets. 2017 Mar 30;:

Authors: Ganguly BB

Abstract
BACKGROUND: Involvement of mutations in epigenetic mechanism in development of heterogeneous MDS and its evolution to AML has been understood with at least one mutation and median of 2-3 mutations of the landscapes of driver mutations in ~40 genes described >90% MDS patients. Exclusivity and cooperating effects of mutations have directed therapeutic implementation with hypomethylating agents and identified a number of first-in-class small molecules as inhibitors of mutational expression. Preclinical and clinical trials have already been initiated for some synthetic and natural products and established proof-of-concept for mitigation of mutagenic effects.
OBJECTIVE: The present review article entails the mutational signatures in DNA-methylation and hydroxymethylation, histone acetylation and deacetylation and polycomb repressor complex (PRC2), and small molecule inhibitors of these mutational expressions.
METHOD: Information has been collected from the recently published literature available mainly through Google search in Medline and PubMed database. Special emphasis was paid on the literature available during 2009-2016.
RESULT: The up-to-date information accumulated on signature-mutations and their inhibitors has to integrate the function of clonal hematopoiesis of indeterminate potential (CHIP) and mutational complexities for re-defining MDS-genesis. Nevertheless, molecular understanding of MDS heterogeneity and its transformation to AML is expanding at fast pace with expanding knowledge on abundant non-coding RNAs (ncRNAs), which forms the basis of targeted drug-tailoring, and will further develop personalized medicines based on individual genetic blue-prints.
CONCLUSION: Mutation-specific targeted epigenetic drugs, which have already sensitized drug-makers and regulators, may promise attestation of 'del5q and lenalidomide'-like specific drugs for every mutational signature independently or in combination with standard therapeutic elements used for MDS-management, and that will add to understand their antagonistic/synergistic effects.

PMID: 28359242 [PubMed - as supplied by publisher]

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