Epigenetic biomarkers in personalized medicine

Increasing evidence reveals that epigenetic biomarkers, mainly markers of DNA methylation or noncoding RNA molecules, can become valuable tools as minimally invasive diagnostic biomarkers in cancerous conditions as well as monitoring disease status over time and predicting favorable or worse outcome. In addition, drugs acting on writer and eraser proteins of the epigenetic marks, such as DNA methyltransferases and histone deacetylases, are among the most promising novel therapeutic approaches in either cancerous or noncancerous conditions. In parallel, there are indications, mainly from studies in cancer cell lines, that most chemotherapeutic and immune resistance is mediated by epigenetic changes, paving the way for epigenetic markers of response to treatment. The role of epigenetics is not confined to cancer onset and progression, but is becoming increasingly recognized in most noncancerous human complex diseases, indicating that the analysis of the epigenome could represent one of the most promising approaches to refining diagnosis, predicting prognosis, and choosing the most personalized therapeutic approach in human disease.