A lthough several drugs aimed at reversing epigenetic modifications—nonsequence changes in DNA—are already the standard of care for some malignancies, the field scaled a major hurdle this spring when investigators showed for the first time that an epigenetic therapy improved overall survival in a randomized phase III trial. An international team, known as the International Vidaza High-Risk MDS Survival Study Group, showed that patients with myelodysplastic syndrome who received azacytidine (Vidaza) survived longer than patients who received other standard treatments.