Department of Medical Oncology, Pisa University Hospital, Pisa, Italy.
BMC Cancer. 2010 Sep 27;10:511. doi: 10.1186/1471-2407-10-511.
The selection of patients according to key genetic characteristics may help to tailor chemotherapy and optimize the treatment in Castration-Resistant Prostate Cancer (CRPC) patients. Functional polymorphisms within the cytochrome P450 1B1 (CYP1B1) gene have been associated with alterations in enzymatic expression and activity and may change sensitivity to the widely used docetaxel regimen.
CYP1B1 genotyping was performed on blood samples of 60 CRPC patients treated with docetaxel, using TaqMan probes-based assays. Association between CYP1B1-142C>G (leading to the 48ArgGly transition), 4326C>G (432LeuVal), and 4390A>G (453AsnSer) polymorphisms and treatment response, progression-free-survival (PFS) and overall-survival (OS) was estimated using Pearson χ2 test, Kaplan-Meier curves and Log-rank test.
Patients carrying the CYP1B1-432ValVal genotype experienced a significantly lower response-rate (P = 0.014), shorter progression-free-survival (P = 0.032) and overall-survival (P < 0.001). Multivariate analyses and correction for multiple comparisons confirmed its prognostic significance for OS. No significant associations were found among other polymorphisms and both response and clinical outcome.
CYP1B1-4326C>G (432LeuVal) polymorphism emerged as possible predictive marker of response and clinical outcome to docetaxel in CRPC patients and may represent a potential new tool for treatment optimization. Larger prospective trials are warranted to validate these findings, which might be applied to the future practice of CRPC treatment.
根据关键的遗传特征选择患者可能有助于定制化疗并优化去势抵抗性前列腺癌(CRPC)患者的治疗。细胞色素 P450 1B1(CYP1B1)基因内的功能多态性与酶表达和活性的改变有关,并且可能改变对广泛使用的多西他赛方案的敏感性。
使用 TaqMan 探针基于测定法,对 60 例接受多西他赛治疗的 CRPC 患者的血液样本进行 CYP1B1-142C>G(导致 48ArgGly 转换)、4326C>G(432LeuVal)和 4390A>G(453AsnSer)多态性的基因分型。使用 Pearson χ2 检验、Kaplan-Meier 曲线和 Log-rank 检验估计 CYP1B1-142C>G(导致 48ArgGly 转换)、4326C>G(432LeuVal)和 4390A>G(453AsnSer)多态性与治疗反应、无进展生存期(PFS)和总生存期(OS)之间的相关性。
携带 CYP1B1-432ValVal 基因型的患者反应率明显降低(P=0.014),无进展生存期(P=0.032)和总生存期(P<0.001)较短。多变量分析和多次比较校正证实了其对 OS 的预后意义。其他多态性与反应和临床结果之间没有发现显著相关性。
CYP1B1-4326C>G(432LeuVal)多态性可能成为 CRPC 患者多西他赛反应和临床结局的预测标志物,可能成为治疗优化的潜在新工具。需要进行更大的前瞻性试验来验证这些发现,这可能应用于未来的 CRPC 治疗实践。