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Epigenetic Inhibitors in Multiple Myeloma Bone Disease: A New Frontier?

By: Cordi Craig
Posted: Monday, April 29, 2019

A review, published in the Journal of Bone and Mineral Research Plus, evaluated the role of epigenetic-based mechanisms involved in multiple myeloma–induced suppression of bone marrow stromal cells, which can cause the development of osteolytic lesions and severe complications affecting morbidity, mortality, and treatment. The authors addressed the role of chromatin-modifying enzymes, epigenetic plasticity, and the potential to employ small-molecule epigenetic inhibitors for the repair and prevention of osteolytic lesions in patients with multiple myeloma.

“In addition to their use as single agents, the multifactorial use of epigenetic inhibitors in combination with conventional drugs opens up yet another frontier of therapeutic intervention against [multiple myeloma bone disease],” concluded Juraj Adamik, PhD, of the University of Pittsburgh, and colleagues.

The study authors conducted a comprehensive review of trials that analyzed the use of anticancer drugs in combination with epigenetic inhibitors, the effect of epigenetic inhibitors on multiple myeloma and osteoblastogenesis, as well as antimyeloma effects and osteoprotective effects.

Often, small-molecule epigenetic inhibitors are studied in cultured cells in the absence of surrounding bone environment. For future studies and research development, the authors stressed the importance of focusing on multiple myeloma in the context of the myeloma bone setting.

“Because epigenetic mechanisms are reversible forms of gene regulation, the use of these agents [epigenetic inhibitors] can be modulated and fine‐tuned to achieve the best bone anabolic effects and minimize the risk of side effects,” the authors commented.

Disclosure: The study authors reported no conflicts of interest.

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