Cited by 55Histone Deacetylase Inhibitors ResearchEpigenetics and DNA MethylationGenomics and Chromatin Dynamics

The DOI matches its Crossref record; 229 of the 229 references it cites were found in a registry or an index; 6 of the 285 sources its claims cite were checked for support.

HDACs and the epigenetic plasticity of cancer cells: Target the complexity

Open access
Brancolini, Claudio, Gagliano, Teresa, Minisini, Martina·2022·Pharmacology & Therapeutics

Abstract

Cancer cells must adapt to the hostile conditions of the microenvironment in terms of nutrition, space, and immune system attack. Mutations of DNA are the drivers of the tumorigenic process, but mutations must be able to hijack cellular functions to sustain the spread of mutant genomes. Transcriptional control is a key function in this context and is controlled by the rearrangement of the epigenome. Unlike genomic mutations, the epigenome of cancer cells can in principle be reversed. The discovery of the first epigenetic drugs triggered a contaminating enthusiasm. Unfortunately, the complexity of the epigenetic machinery has frustrated this enthusiasm. To develop efficient patient-oriented epigenetic therapies, we need to better understand the nature of this complexity. In this review, we will discuss recent advances in understanding the contribution of HDACs to the maintenance of the transformed state and the rational for their selective targeting.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review argues that HDACs are critical but context-dependent regulators of cancer, with both pro-oncogenic and tumor-suppressive activities, so selective targeting requires understanding their multiprotein complexes. It surveys class I, IIa, and IV HDACs and their roles in therapy, resistance, and immunotherapy.

Key findings

  • As single agents, HDAC inhibitors are clinically limited to cutaneous T-cell lymphoma and peripheral T-cell lymphoma; all approved HDACIs are pan-selective inhibitors of zinc-dependent HDACs. A ClinicalTrials.gov snapshot reports 725 HDACI cancer trials: 351 completed, 137 terminated, 80 recruiting, 60 active not recruiting, 50 unknown, and 32 withdrawn; by phase, 424 phase 1, 387 phase 2, 30 phase 3, and 3 phase 4.
  • HDAC1/2, HDAC3, HDAC8, class IIa HDACs, and HDAC11 show context-dependent effects. For example, in GBM, HDAC1 silencing affects glioma stem cell proliferation, but in vivo absence of HDAC1 leads to a more aggressive/invasive phenotype via STAT3; high HDAC1 expression correlates with poorer prognosis, whereas HDAC2 expression correlates with better prognosis.
  • Immunotherapy combinations are highlighted: in the phase 2 PEMDAC trial, entinostat plus pembrolizumab in metastatic uveal melanoma achieved a median overall survival of 13.4 months versus a ten-month historical benchmark; in metastatic clear cell renal cell carcinoma, entinostat with high-dose IL2 downregulated Fox3p and reduced Tregs.
  • HDAC8 is frequently overexpressed in tumors; the HDAC8 inhibitor PCI-34051 decreases cell growth and causes apoptosis in T-cell-derived tumor lines, and HDAC8 deletion significantly reduces AML incidence while HDAC8 inhibition increases chemotherapy sensitivity in mice and patients.

Methods

  • Narrative review; no primary experimental data are reported. The paper focuses on zinc-dependent HDACs in classes I, IIa, and IV and their contribution to cancer and therapeutic targeting.
  • Data sources are published literature and clinical trial data obtained from ClinicalTrials.gov, including 725 clinical trials using HDACIs for cancer treatment.
  • Main analysis is a qualitative synthesis by HDAC class/isoform, covering structural features, multiprotein complexes, oncogenic and tumor-suppressive functions, DNA damage response, immunotherapy, resistance, and inhibitors.

Limitations

  • Stated by the authors: it remains unclear how HDACs select the right substrate in a time- and context-dependent manner; little is known about the multiprotein complexes that accompany different HDACs; and space limitations prevented citing all relevant manuscripts.
  • Stated by the authors: HDACs are frequently implicated in cancer but do not always involve epigenetic targets, and conflicting results exist about their biological functions.
  • Evident from the text: this is a narrative review without a systematic search or quantitative meta-analysis; many mechanistic claims derive from preclinical models, cell lines, or mouse studies, and the clinical trial data are descriptive registry counts rather than patient-level outcomes.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.pharmthera.2022.108190

Cites

229 of 229 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

246 Not checked yet · 17 Own interpretation · 4 Supported · 2 Partly supported · accuracy not yet measured

Verify all 279 references — free account
  • Probably not a substantial claim. 19
  • It may state two separate claims as one. 80
91 of 91
  • The paper relies on this without support.

    The epigenome of cancer cells can in principle be reversed.

    “Unlike genomic mutations, the epigenome of cancer cells can in principle be reversed.”
  • The paper relies on this without support.

    Transcriptional control is a key function in cancer and is controlled by rearrangement of the epigenome.

    “Transcriptional control is a key function in this context and is controlled by the rearrangement of the epigenome.”
  • The paper relies on this without support.

    DNA mutations must hijack cellular functions to sustain the spread of mutant genomes.

    “Mutations of DNA are the drivers of the tumorigenic process, but mutations must be able to hijack cellular functions to sustain the spread of mutant genomes.”
  • The paper relies on this without support.

    The complexity of the epigenetic machinery has frustrated enthusiasm for epigenetic drugs.

    “Unfortunately, the complexity of the epigenetic machinery has frustrated this enthusiasm.”
  • The paper relies on this without support.

    HDAC activities need to be hijacked to maintain the transformation state.

    “i) their activities need to be hijacked to maintain the transformation state”
  • The paper relies on this without support.

    HDACs are directly responsible for transformation events.

    “ii) they are directly responsible for transformation events.”
  • The paper relies on this without support.

    HDAC5 acts as a senescence antagonist.

    “Similarly, HDAC5 may also act as a senescence antagonist.”
  • The paper relies on this without support.

    HDAC1 and HDAC3 are involved in maintaining the high expression of HDAC7.

    “HDAC1 and HDAC3 appear to be involved in maintaining the high expression of HDAC7 in an undetermined manner.”
  • The paper relies on this without support.

    HDACs are frequently implicated in cancer.

    “Although frequently implicated in cancer, they do not always involve epigenetic targets.”
9 of 9

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Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

1 of 1

Citations

Cites

Show all 229 references

Research works printed but not linked: 1

  1. Gil, 2016, Deregulated expression of HDAC9 in B cells promotes development of lymphoproliferative disease and lymphoma in mice, Disease Models & Mechanisms, 9, 1483

Cited by

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Metadata

Authors
Brancolini, C., Gagliano, T., & Minisini, M.
Affiliations
University of Udine (IT)
Corresponding author
Brancolini, Claudio
Venue
Pharmacology & Therapeutics
Publisher
Elsevier BV
Published
2022-10
Volume
238
Pages
108190
ISSN
0163-7258 (ISSN-L)
OpenAlex
W4226377997
Cited by
55
References
229
Citations by year
2026: 9 · 2025: 20 · 2024: 14 · 2023: 9 · 2022: 3
FWCI
1.22
Type
journal article
Language
en
Open access
Locations
  • Pharmacology & Therapeutics (publishedVersion, cc-by-nc-nd)
  • SSRN Electronic Journal (publishedVersion)
  • PubMed (publishedVersion)
  • Institutional Research Information System (University of Udine) (submittedVersion, cc-by)
Funders
  • Interreg
  • European Commission
  • Associazione Italiana per la Ricerca sul Cancro
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Histone Deacetylase Inhibitors Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Epigenetics and DNA Methylation
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Genomics and Chromatin Dynamics
Keywords
histone deacetylase, epigenetic plasticity, cancer cells, epigenetic therapy, transcriptional regulation, epigenetic drugs, selective targeting, tumor microenvironment
MeSH terms
Histone Deacetylases, Humans, DNA Methylation, Epigenesis, Genetic, Epigenomics, Tumor Microenvironment, Carcinogenesis

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