Abstract
Epigenetic aberrations contribute to the onset and progression of cancer. This process often includes the epigenetically driven suppression of cancer immunity. Epigenetic modifications in the DNA methylation pattern and/or chromatin landscape results in alterations in gene expression leading to phenotypic changes in cancer and microenvironment cells. The immune system plays a critical role in cancer development and progression by eliminating cancer cells. In turn, cancer cells escape from the immune system by expressing suppressive phenotypes and decreasing immunogenicity (i.e., losing target antigens and neoantigens). In addition, epigenetic alterations can directly reprogram immune microenvironment cells causing poor immune cell infiltration and effector cell dysfunction and exhaustion resulting in an immunosuppressive microenvironment. Cancer immunotherapy includes drugs and biological agents that aim to improve cancer immunity. In some tumors, the antineoplastic effect of these therapeutic strategies is diminished due to the development of resistant mechanisms in cancer and microenvironmental cells that can be epigenetically driven. In this chapter, we will discuss the potential use of epigenetic agents to increase the cancer immunity and prime cancer and immune cells for the activity of immunotherapy
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