Targeting epigenetic modifications for the treatment and prevention of breast cancer

DNA methylation, histone modification, and nucleosome remodeling are the three intercalated events that result in epigenetic modification, which in turn alters gene expression. Aberrant epigenetic regulation resulting in altered gene expression has been clearly implicated in the initiation and progression of breast cancer. Our understanding of the landscape of these changes in breast cancer has increased tremendously over the past decade. Significant advancement has been made in the preclinical arena to identify targets that are epigenetically altered in breast cancer and to modulate these targets with epigenetic therapies to improve tumor response. Clinical translation of these concepts is currently ongoing and shows promise in improving outcomes in breast cancer. This article provides a comprehensive review of the completed and ongoing clinical trials of epigenetic therapy in the management and prevention of breast cancer and the rationale leading to the design of these trials.