FUTURE PERSPECTIVES OF EPIGENETIC DRUGS IN ORAL CANCER

Oral cancer, predominantly in the form of squamous cell carcinoma, affects 500,000 people worldwide each year and is the most common head and neck cancer. Major risk factors are the use of tobacco and alcohol consumption, which induce multistep carcinogenesis and multifocal neoplastic lesions in the exposed epithelial field. There have been major improvements in the treatment of oral cancer thanks to surgical techniques, radiotherapy, chemotherapy and gene therapy. In addition to genetic changes, epigenetic modifications play a pivotal role in the development of this neoplastic disease. Epigenetics is defined as the study of mitotically and/or meiotically heritable changes in gene function that cannot be explained by changes in DNA sequence. Epigenetics has allowed a novel molecular vision of organisms, and provides alternative solutions to the reductionist genetic approach, providing explanations to the regulatory mechanisms of gene expression by DNA and chromatin modifications. DNA methylation triggers histone deacetylation, chromatin condensation, and gene silencing. We will discuss briefly these epigenetic "marks" and their important implications in cancer screening. Used in early detection, prevention, classification for epidemiology and prognostic purposes, novel epigenetic drugs show favorable clinical outcomes and promising preliminary data.