The epigenetics of oral cancer

Whilst genetic alterations in oral cancer have long been documented, the appreciation of epigenetic changes is more recent. Epigenetic changes alter expression of tumour suppressor genes without changes in DNA sequence. Epigenetic mechanisms such as DNA methylation, histone methylation and deacetylation have been shown to silence key genes involved in cell proliferation, differentiation and genome integrity, and clearly have a central role in oral cancer. The pattern of hypermethylation in any individual tumour can now be accurately determined, which may find application in molecular staging. In addition, current trials are evaluating the safety and efficacy of agents affecting epigenetic changes in cancer patients which hold some therapeutic promise.