Bromodomains: a new target class for drug development

Less than a decade ago, it was shown that bromodomains, acetyl lysine ‘reader’ modules found in proteins with varied functions, were highly tractable small-molecule targets. This is an unusual property for protein–protein or protein–peptide interaction domains, and it prompted a wave of chemical probe discovery to understand the biological potential of new agents that targeted bromodomains. The original examples, inhibitors of the bromodomain and extra-terminal (BET) class of bromodomains, showed enticing anti-inflammatory and anticancer activities, and several compounds have since advanced to human clinical trials. Here, we review the current state of BET inhibitor biology in relation to clinical development, and we discuss the next wave of bromodomain inhibitors with clinical potential in oncology and non-oncology indications. The lessons learned from BET inhibitor programmes should affect efforts to develop drugs that target non-BET bromodomains and other epigenetic readers. Bromodomains are attractive targets from a chemical and structural perspective. The promising therapeutic effects of BET bromodomain inhibitors prompted chemical probe development to understand the potential of new agents targeting bromodomains. This Review discusses the next wave of bromodomain inhibitors with clinical potential in oncology and non-oncology indications.