Changing paradigms in oncology: Toward noncytotoxic treatments for advanced gliomas

Int J Cancer. 2022 Nov 1;151(9):1431-1446. doi: 10.1002/ijc.34131. Epub 2022 Jun 16.

Abstract

Glial-lineage malignancies (gliomas) recurrently mutate and/or delete the master regulators of apoptosis p53 and/or p16/CDKN2A, undermining apoptosis-intending (cytotoxic) treatments. By contrast to disrupted p53/p16, glioma cells are live-wired with the master transcription factor circuits that specify and drive glial lineage fates: these transcription factors activate early-glial and replication programs as expected, but fail in their other usual function of forcing onward glial lineage-maturation-late-glial genes have constitutively "closed" chromatin requiring chromatin-remodeling for activation-glioma-genesis disrupts several epigenetic components needed to perform this work, and simultaneously amplifies repressing epigenetic machinery instead. Pharmacologic inhibition of repressing epigenetic enzymes thus allows activation of late-glial genes and terminates glioma self-replication (self-replication = replication without lineage-maturation), independent of p53/p16/apoptosis. Lineage-specifying master transcription factors therefore contrast with p53/p16 in being enriched in self-replicating glioma cells, reveal a cause-effect relationship between aberrant epigenetic repression of late-lineage programs and malignant self-replication, and point to specific epigenetic targets for noncytotoxic glioma-therapy.

Keywords: cancer epigenetics; epigenetic; glioma; glioma therapy; neurooncology.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain Neoplasms* / drug therapy
  • Brain Neoplasms* / genetics
  • Chromatin
  • Cyclin-Dependent Kinase Inhibitor p16 / genetics
  • Glioma* / drug therapy
  • Glioma* / genetics
  • Glioma* / pathology
  • Humans
  • Transcription Factors / genetics
  • Tumor Suppressor Protein p53 / genetics

Substances

  • Chromatin
  • Cyclin-Dependent Kinase Inhibitor p16
  • Transcription Factors
  • Tumor Suppressor Protein p53