Liver Cancer (Hepatocellular Carcinoma)

Liver cancer is global health problem, claiming hundreds of thousands of deaths every year. Despite significant efforts by doctors, scientists and the pharmaceutical industry, treatment options for hepatocellular carcinoma (HCC) remain poor, with 5-year survival rates of approximately 15%. The paucity of viable clinical treatments available for HCC patients has prompted many to look outside the boundaries of traditional cytotoxic chemotherapeutic and consider targeting the epigenetic make up of malignant hepatocytes. Most commonly, this approach is aimed at altering the activity of histone deacetylases, a family of 18 proteins that play an important role in gene regulation, along with DNA methylation. The role of central epigenetic mechanisms in cancer treatment was originally proposed to result from a normalization of aberrant gene regulation within tumors but is now understood to be far more wide reaching, with significant effects demonstrated against a variety of cellular processes, including metabolism, migration, proliferation, and endoplasmic reticulum stress. The advent of powerful tools in the form of epigenetic agents that have the potential to alter the course of HCC has been highlighted. Nonetheless, this rough diamond needs further refinement and more clarity to truly access their potential benefit. Increases in HCC cases hand in hand with limited treatment options and persistently low survival rates make epigenetic agents a glimmer of hope in the fight against liver cancer.