NSD Family-Mediated H3K36 Methylation in Human Cancer: Mechanisms and Therapeutic Opportunities

Histone H3 lysine 36 (H3K36) methylation, a pivotal epigenetic mark that ensures transcriptional fidelity and genomic integrity, plays an essential role in development and tumorigenesis. The nuclear receptor-binding SET domain (NSD) family of histone methyltransferases, comprising NSD1, NSD2, and NSD3, primarily catalyzes mono- and di-methylation of H3K36 (H3K36me1/2) and engages with chromatin-associated and transcriptional regulatory complexes in a context-dependent manner. Increasing evidence demonstrates that NSD family members have emerged as critical drivers in human cancers. Recurrent gene amplifications, point mutations, and oncogenic fusions of NSD family genes are frequently observed in both solid and hematologic cancers. Their dysregulation contributes to tumorigenesis, cancer cell proliferation and survival, and metastatic progression through both H3K36 methylation-dependent and -independent mechanisms. Pharmacological inhibition of NSD catalytic activity, as well as alternative approaches such as targeted protein degradation or disruption of cofactor interactions, are emerging as promising therapeutic strategies for cancer treatment. This review summarizes the structural features, molecular functions, and cancer-associated alterations and mechanisms of the NSD family and highlights recent advances in targeting these enzymes as potential epigenetic vulnerabilities in cancer.