Table 3 Epigenetic drugs used in liver cancer-related clinical trials
Drug | Target/MOA | Clinical status for HCC | Findings/results | Ref |
|---|---|---|---|---|
Azacytidine | Inhibits DNMT (acts as cytidine analogue) | Pre-clinical | Induce differentiation as a form of epigenetic reconditioning to sensitise tumor cells to sorafenib | [81] |
Decitabine + chemo- or immunotherapy | Inhibits DNMT (acts as cytidine analogue) | Phase I/II (NCT01799083) | Re-sensitise tumor cells to sorafenib; effective and safe at low doses alone and in combination with chemo- or adoptive immunotherapy | |
Guadecitabine (SGI-110) + sorafenib + oxaliplatin | Inhibits DNMT (dinucleotide of deoxyguanosine and decitabine) | Phase II (NCT01752933) | Suppress tumor growth and progression, induce re-expression of silenced TSGs, alone or in combination with sorafenib; pre-treatment potentiates anti-tumor effects of oxaliplatin | |
Panobinostat | HDAC | Pre-clinical | Inhibit proliferation, induce alternative apoptosis pathways, promote differentiation and less invasive phenotype, mediate anti-angiogenic effects and cancer metabolism | |
Belinostat (PXD-101) | HDAC | Phase I/II (NCT00321594) | 45% patients achieved stable disease; HR23B identified as response biomarker | |
Resminostat + sorafenib | HDAC | Phase I/II (NCT00943449) | Induce more epithelial phenotype and potentiate sorafenib-induced cell death; combination treatment with sorafenib prolonged TTP and OS in HCC patients | |
CUDC-101 | Inhibits HDAC, EGFR, HER2 | Phase Ib (NCT01171924) | Block tumor growth in vitro and in vivo; acceptable safety profile in patients | |
Anti-miR-221 | Inhibits miR-221 (AMO) | Pre-clinical | Inhibit tumorigenic effects of miR-221; miRNA sponges sustain miR-221 depletion and induce apoptosis | |
Miravirsen | Inhibits miR-122 (LNA-modified AMO) | Phase IIa (NCT01200420) | Highly specific for miR-122; sustained suppression of HCV infection with high genetic barrier to resistance in patients; no long-term safety issues or AE | |
miR-185 mimic | Exogenous miR-185 oligonucleotide | Pre-clinical | Suppress tumor cell proliferation and invasion; targets DNMT1/PTEN/Akt axis | [111] |