Pharmacogenetic analysis of advanced non-small-cell lung cancer patients treated with first-line paclitaxel and carboplatin chemotherapy.

Pharmacogenet Genomics

aDepartment of Pharmacology and Brain Korea 21 Plus Project for Medical Sciences bDepartment of Internal Medicine, Division of Medical Oncology cDepartment of Nuclear Medicine, College of Medicine, Yonsei University, Seoul dDepartment of Internal Medicine, Division of Medical Oncology, CHA University Bundang Medical Center, Seongnam eDepartment of Pharmacology and PharmacoGenomics Research Center, College of Medicine, Inje University, Busan, Korea.

Published: March 2016

AI Article Synopsis

  • Genetic polymorphisms affect how patients with advanced non-small-cell lung cancer (NSCLC) respond to chemotherapy drugs paclitaxel and carboplatin.
  • A study involving 194 patients identified specific gene variants linked to increased risk of severe anemia and poorer survival outcomes after treatment.
  • Notably, patients with certain genetic markers (SLCO1B3 and ABCB1) demonstrated worse progression-free survival rates, highlighting the potential for personalized medicine in cancer treatment based on genetic profiles.

Article Abstract

Background: Genetic polymorphisms contribute toward interindividual variations in drug response. We investigated the effects of genetic polymorphisms on the clinical outcome of advanced non-small-cell lung cancer patients with first-line paclitaxel and carboplatin.

Materials And Methods: A total of 194 non-small-cell lung cancer patients were prospectively enrolled from January 2010 to January 2013. We genotyped 11 polymorphisms in seven genes involved in the glycolysis pathway and the related pharmacokinetic/pharmacodynamic pathway. Genetic associations with PET-SUV, survival outcome, and toxicity were analyzed, and in-vitro drug transport activity was measured in the oocyte system.

Results: Patients with the c.334 T>G and c.699 G>A homozygous variant in SLCO1B3 showed a higher incidence of grade 3/4 anemia (P=0.002). Transport activities of oocyte that overexpress the SLCO1B3 c.699 G>A variant showed a significantly decreased uptake of paclitaxel compared with the wild-type expressing oocytes. In addition, patients with GG/GA/AA genotypes of ABCB1, c.2677 T>G/A locus showed inferior progression-free survival (hazard ratio=1.49, P=0.017) compared with other genotypes. The GA genotype of HIF1A, c.1834 G>A locus was associated with inferior progression-free survival compared with the GG genotype (hazard ratio=2.47, P=0.008).

Conclusion: This study showed that the SLCO1B3 c.699 G>A polymorphism may predict anemia and ABCB1, HIF1A polymorphism are highly predictive for worse survival in advanced NSCLC with first-line paclitaxel and carboplatin.

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http://dx.doi.org/10.1097/FPC.0000000000000196DOI Listing

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