Epigenetics: the master switch of nasopharyngeal carcinoma invasion and metastasis

Nasopharyngeal carcinoma (NPC) is a metastasis-prone malignancy that is highly prevalent in endemic regions. Epigenetic dysregulation, including aberrant DNA/RNA/protein methylation, histone modifications, and non-coding RNA networks, contributes to NPC invasion and metastasis by reshaping epithelial-mesenchymal transition, tumor microenvironment interactions, immune evasion, and therapy adaptation. This review provides a structured overview of the core mechanisms of epigenetic regulation in NPC, highlighting aberrant methylation (DNA, RNA, protein), histone post-translational modifications (acetylation, phosphorylation, ubiquitination, palmitoylation), and the dysregulation of non-coding RNAs. We also summarize current translational progress, including biomarker development and early NPC-specific epigenetic trials, while highlighting the major barriers to clinical implementation, such as tumor heterogeneity, off-target effects, and insufficient validation. Overall, this review integrates mechanistic and translational evidence to clarify how epigenetic insights may support biomarker-guided and precision-oriented management of NPC.