Epigenetic alterations in oral cancer: Mechanisms, biomarkers, and therapeutic targets

Epigenetic alterations play an important aspect in the pathogenesis of oral cancer, affecting gene regulation occurs without altering the DNA sequence itself. These alterations include processes like DNA methylation, histone modification, and the regulation mediated by non-coding RNAs (ncRNAs), contribute to the initiation, progression, and metastasis of oral squamous cell carcinoma (OSCC). This review comprehensively examines the major epigenetic mechanisms implicated in oral cancer, elucidates potential biomarkers for early detection and prognosis, and explores emerging epigenetic therapies with significant potential for targeted treatment. The reversible characteristics of epigenetic modifications render them promising therapeutic targets and offers hope for improved clinical outcomes. We also discuss the current limitations in research and suggest future directions for developing effective epigenetic-based diagnostic and therapeutic strategies. • Mechanisms of Epigenetic Alterations : Explore how DNA methylation, histone modifications, and non-coding RNAs contribute to the dysregulation of gene expression in oral cancer, driving tumor initiation and progression. • Emerging Biomarkers : Highlight novel epigenetic biomarkers that are being identified for early detection, diagnosis, and prognosis of oral cancer, focusing on their potential clinical relevance. • Therapeutic Targets : Examine current therapeutic strategies targeting epigenetic regulators, such as DNA methyltransferase inhibitors and histone deacetylase inhibitors, offering new avenues for oral cancer treatment. • Personalized Medicine : Discuss how integrating epigenetic profiling could lead to more personalized and effective treatment plans, optimizing patient outcomes in oral cancer therapy.