Histone Deacetylases and Their Inhibitors: Classification, Clinical Development, and FDA-Approved Therapeutic Indications

Abstract

Histone deacetylases (HDACs) are vital regulators of gene expression and chromatin structure. Their abnormal overactivity has been closely linked to the progression of various solid tumors, making them a significant focus of cancer research. HDAC inhibitors (HDACis) have shown clinical promise, particularly in the treatment of hematological cancers, but their use in solid tumors has been limited by modest effectiveness and safety concerns. This review outlines the classification and biological roles of HDACs, the mechanisms underlying HDAC inhibition, and therapeutic advances made through combination treatments involving chemotherapy, targeted drugs, and epigenetic agents. Importantly, the discussion also considers how HDAC-based therapies can align with the principles of sustainable development. By emphasizing the need for safer, more selective treatments that minimize harm to healthy cells and reduce long-term toxicity, the paper highlights the importance of developing cancer therapies that are not only effective but also responsible and sustainable. As cancer care evolves, integrating sustainability into drug development—through smarter design, improved delivery systems, and personalized strategies—offers a more balanced and forward-looking approach to managing solid tumors.