Current opinion on the pharmacogenomics of paclitaxel-induced toxicity.

Expert Opin Drug Metab Toxicol

Department of Genetics and Genomics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.

Published: July 2021

AI Article Synopsis

  • - Paclitaxel, a widely used chemotherapy drug, is effective in treating various cancers but is associated with significant neurotoxicity and other adverse effects, prompting research into its safety profile.
  • - The review discusses mechanisms and risk factors behind paclitaxel-induced toxicities, focusing on pharmacogenomic biomarkers, with specific attention to genes linked to neuro-sensitivity as promising candidates for further investigation.
  • - Genome-wide studies have identified various candidate genes related to neuro-sensitivity, suggesting future research should explore these genes and their multifactorial influences on toxicity rather than relying solely on pharmacokinetic pathways, which have shown inconsistent results.

Article Abstract

: Paclitaxel is a microtubule stabilizer that is currently one of the most utilized chemotherapeutic agents. Its efficacy in breast, uterine, lung and other neoplasms made its safety profile enhancement a subject of great interest. Neurotoxicity is the most common paclitaxel-associated toxicities. In addition, hypersensitivity reactions, hematological, gastrointestinal, and cardiac toxicities are all encountered.: The current review explores paclitaxel-induced toxicities mechanisms and risk factors. Studies investigating these toxicities pharmacogenomic biomarkers are reviewed and summarized. There is a limited margin of consistency between the retrieved associations. Variants in genes related to neuro-sensitivity are the most promising candidates for future studies.: Genome-wide association studies highlighted multiple-candidate biomarkers relevant to neuro-sensitivity. Most of the identified paclitaxel-neurotoxicity candidate genes are derived from congenital neuropathy and diabetic-induced neurotoxicity pathways. Future studies should explore these sets of genes while considering the multifactorial nature of paclitaxel-induced neurotoxicity. In the absence of certain paclitaxel-toxicity biomarkers, future research should avoid earlier studies' caveats. Genes in paclitaxel's pharmacokinetic pathways could not provide consistent results in any of its associated toxicities. There is a need to dig deeper into toxicity-development mechanisms and personal vulnerability factors, rather than targeting only the genes suspected to affect drug exposure.

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http://dx.doi.org/10.1080/17425255.2021.1943358DOI Listing

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