Epigenetics At A Glance
Compared to standard chemotherapy, what are the side effects of epigenetic therapy?
The standard way of developing drugs in oncology is to take a drug and give it at the highest possible dose that will not kill the patient. The key really has been the realization that you don't need to do that for epigenetic-acting drugs. All you need is to give enough of it to change the epigenetic patterns in the cancer cells to have a therapeutic effect. Therefore, we have backed down substantially from the very toxic doses of these drugs to doses that right now, we are very happy to say, have very minimal side effects (17)​
An Interview On Dr. Jean-Pierre and His Study on Epigenetic Therapy And Its Impact; Done By PBS's Nova
So when you say epigenetic therapy, you're not going in and trying to kill the cancer cells. What are you trying to do?
The idea of epigenetic therapy is to stay away from killing the cell. Rather, what we are trying to do is diplomacy, to change the instructions of the cancer cells. You see, cancer cell start out as normal cells. They have the set of instructions that is present in every one of our cells.
In the process of becoming cancer, a lot of these instructions are forgotten because specific genes that regulate the behavior of a cell are turned off by epigenetics. And epigenetic therapy really aims at reminding the cell that, "Hey, you're a human cell, you shouldn't be behaving this way." And we try to do that by reactivating genes, by bringing back the expression of these genes that have been silenced in the cancer cell and letting those genes do the work for us (17)​
What made you think this cancer was epigenetic in origin?
MDS, perhaps more so than many other cancers, is a disease of older people with a median age of 70. Older individuals have prominent epigenetic changes compared to newborns or even young individuals. Therefore, any disease of the old is likely to have an epigenetic component.
But even cancers in young people can have epigenetic changes. So MDS is, in this respect, not all that different from other cancers. What is different is that MDS is a disease where these drugs that affect epigenetics were found to be particularly effective (17)​
You've studied one kind of cancer, MDS, that appears to be caused by epigenetics. Can you tell me in the simplest terms, what is MDS?
If you look at the bone marrow of a patient with MDS, Myelodysplastic Syndrome, what you will see is 99% cancer cells. Those cancer cells are doing what cancers do, which is copy themselves tirelessly. And they continue to crowd out the tissue and prevent the normal function of that particular tissue. Bone marrow makes blood cells: the cells that carry oxygen, the red blood cells; the cells that fight infections, the white blood cells; and the cells that prevent bleeding with platelets. All of these cells become abnormal in patients with MDS, who typically have very low levels of these cells
Patients, unfortunately, die of this disease. They die of bleeding. They die of severe anemia and heart attacks, for example. Or some patients die of overwhelming infections because they are unable to mount an immune response to these infections. (17)​