癌症治疗的终极目标是从患者身上消除疾病。最直接的方式是通过治疗诱导细胞死亡实现。若能持久，治疗诱导的细胞生长停滞也是期望的结果。不幸的是，治疗诱导的细胞生长停滞很少是持久的，恢复的细胞数量可能会导致癌症复发。因此，消除残留癌细胞的治疗策略可以减少复发机会。恢复可以通过各种机制发生，包括静止或滞育、退出增龄期、抑制凋亡、细胞保护性自噬和由多倍体引起的还原性分裂等。基因组的表观遗传调控代表了某种基本的调节机制，与癌症特异性生物学紧密联系，包括从治疗中恢复。表观遗传途径尤其具有吸引力的治疗靶点，因为它们是可逆的，没有DNA的变化，并且是由可靶向的酶催化的。先前使用表观遗传靶向治疗与癌症治疗相结合并不普遍成功，因为要么有无法接受的毒性，要么疗效有限。在初始的癌症治疗之后经过相当时间以后使用表观遗传靶向治疗，有可能减少组合策略的毒性，并有可能利用治疗暴露后必需的表观遗传状态。本综述评估了使用连续方法靶向表观遗传机制消除残余的治疗停滞人群，可能可以预防恢复和疾病复发的可行性。www.wdnlive.com 版权所有。

The ultimate goal of cancer therapy is the elimination of disease from patients. Most directly, this occurs through therapy-induced cell death. Therapy-induced growth arrest can also be a desirable outcome, if prolonged. Unfortunately, therapy-induced growth arrest is rarely durable and the recovering cell population can contribute to cancer recurrence. Consequently, therapeutic strategies that eliminate residual cancer cells reduce opportunities for recurrence. Recovery can occur through diverse mechanisms including quiescence or diapause, exit from senescence, suppression of apoptosis, cytoprotective autophagy, and reductive divisions resulting from polyploidy. Epigenetic regulation of the genome represents a fundamental regulatory mechanism integral to cancer-specific biology, including the recovery from therapy. Epigenetic pathways are particularly attractive therapeutic targets because they are reversible, without changes in DNA, and are catalyzed by druggable enzymes. Previous use of epigenetic-targeting therapies in combination with cancer therapeutics has not been widely successful because of either unacceptable toxicity or limited efficacy. The use of epigenetic-targeting therapies after a significant interval following initial cancer therapy could potentially reduce the toxicity of combination strategies, and possibly exploit essential epigenetic states following therapy exposure. This review examines the feasibility of targeting epigenetic mechanisms using a sequential approach to eliminate residual therapy-arrested populations, that might possibly prevent recovery and disease recurrence.Copyright © 2023 Elsevier Inc. All rights reserved.