Hallmark (2022): non-mutational epigenetic reprogramming
Cancers can change behaviour, including becoming drug-tolerant, without any new mutation, by rewriting the chemical tags that control which genes are read.
Drug-tolerant persister states, microenvironment-induced chromatin changes, and epigenetic silencing of tumour suppressors and antigens. Reversible in principle: hypomethylating agents, HDAC/EZH2/BET inhibitors, and epigenetic priming before immunotherapy.
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