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Future Trials
Histone Deacetylase (HDAC) Inhibitors
HDAC regulates DNA expression and because of this can potentially shift uveal melanoma cells from the class 2 to the class 1 signature. HDAC inhibitors have been shown to induce differentiation of uveal melanoma cells and dormancy of micrometastatic disease. HDAC inhibitors, including suberolanilide hydroxamic acid and valproic acid, are used clinically and are being considered for adjuvant testing in patients with high-risk uveal melanoma.
Hypomethylating Agents
DNA methylation is mediated by DNA methyl-transferase. In melanoma models frequent, intermittent, low concentrations of the DNA methyl-transferase inhibitor, decitabine has been shown to suppress proliferation and promote cellular differentiation. Frequent, intermittent, low-dose decitabine also induced alterations in potential host regulators of MITF in the tumor stroma. Host immune cells were also modified. An adjuvant trial of low-dose decitabine, which is in clinical use, in patients with high-risk uveal melanoma is being activated.
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