Delivering top quality medical education requires awareness and understanding of new developments in biology that impact treatment of disease. INNOTIO’s medical team makes sure that the most current research is reflected in our educational initiatives. Epigenetics is an important example of how evolution in our basic understanding of gene expression is changing medicine. Studies of identical twins carried out over the last two centuries have made clear that genetic inheritance does not completely determine phenotype and epigenetics has provided part of the reason why this is the case. Epigenetics literally means „on top of“ genetics and it is the study of external modifications to DNA that change how it is expressed (turned on or off) in cells. Remarkably, some of these epigenetic changes can be passed from one generation to the next and this provides potential explanations for why genetic determinants may not fully explain the inheritance of complex traits as well as our failure to identify causative genetic effects in some diseases. Over 20 years ago, epigenetic mechanisms were shown to contribute to the development of colorectal cancer and subsequent studies have demonstrated links to many other common diseases. Agents aimed at reversing deleterious changes in DNA expression are now being used to treat specific malignancies (e.g., multiple myeloma) and are in development in many more therapeutic areas.