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The aim of targeted therapies is to inhibit the driving set of molecules, or pathways, in cancer. New research regarding tumor drivers and escape pathways has led researchers to investigate combinational therapies in cancer, either through simultaneous or sequential application. In this article, we discuss a strategy to inhibit the actionable targets while blocking feedback loops, by epigenetic therapies and recognizing and understanding the role these treatments play in controlling escape pathways. We present a case of a patient with a neuroendocrine tumor of the liver who was treated with this strategy. Our results showed a positive response and led us to conclude that further studies are needed to structure an enhanced analysis of tumor escape pathways. This would enable us to formulate more effective therapies in neuroendocrine tumor as well as other solid tumors. *Correspondence to: MA Nezami, President, Orange Coast Medical Center of Hope Inc., USA, E-mail: amnezami@yahoo.com

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Preliminary findings on a sequential and combined targeted epigenetic therapy through MAPK and MEK inhibition: A case study of advanced neuroendocrine malignancy