Epigenetics modulates the complexity of the response to Immune Checkpoint Blockade.

Abstract

The emergence of Immune Checkpoint Blockade (ICB) therapy has unleashed an abundance of promising cancer treatment alternatives that focus on the re-activation of an immunosuppressed tumour environment. These strategies, initially applied to advanced stages of cancer with durable responses and acceptable toxicity, are also transforming the clinical practice in the adjuvant and neoadjuvant settings and are indicated in more than 15 types of tumours. However, the frequent occurrence of innate or acquired resistance, of up to 85% of the patients, has turned the focus on precision medicine to decipher which patients will benefit from the treatment, and on combination therapies with multiple targets that can holistically combat the disease [1]. In this context, despite a nascent instrument in clinical practice, epigenetic marks stand as putative biomarkers informative both of response to immunotherapy and of the disease or therapy-induced dynamic landscape.