Germline pharmacogenetics of paclitaxel for cancer treatment.

Paclitaxel is a highly effective chemotherapeutic agent used in a variety of solid tumors. Some paclitaxel-treated patients experience the intended therapeutic response with manageable side effects, while others have minimal response and/or severe toxicity. This variability in treatment outcome is partially determined by variability in drug exposure (pharmacokinetics) and by patient and tumor sensitivity (pharmacodynamics). Both pharmacokinetics and pharmacodynamics are dictated in part by common variants in the germline genome, known as SNPs. This article reviews the published literature on paclitaxel pharmacogenetics in cancer, focusing primarily on polymorphisms in genes relevant to paclitaxel pharmacokinetics and discusses preliminary work on pharmacodynamic genes and genome-wide association studies.