Abstract
Cancer is traditionally viewed as a primarily genetic disorder, however
it is now becoming accepted that cancer is also a consequence of
abnormal epigenetic events. Genetic changes and aneuploidy are associated
with alterations in DNA sequence, and they are a hallmark of the
malignant process. Epigenetic alterations are universally present
in human cancer and result in heritable changes in gene expression
and chromatin structure over many cell generations without changes
in DNA sequence, leading to functional consequences equivalent to
those induced by genetic alterations. Importantly, intriguing evidence
emerged suggesting that epigenetic changes may precede and provoke
genetic changes. In this scenario, epigenetic events are primary
events while genetic changes (such as mutations) may simply be a
consequence of disrupted epigenetic states. This fact may explain
why many genetic screens proved to be limited with regard to cancer
causality and pathogenesis. Aberrant epigenetic events affect multiple
genes and cellular pathways in a non-random fashion and this can
predispose to induction and accumulation of genetic changes in the
course of tumour initiation and progression. These considerations
are critical for a better understanding of tumourigenesis and molecular
events underlying the acquisition of drug resistance, as well as
development of novel strategies for cancer therapy and prevention.
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