Diekstra Meta H M, Liu Xiaoyan, Swen Jesse J, Boven Epie, Castellano Daniel, Gelderblom Hans, Mathijssen Ron H J, Rodríguez-Antona Cristina, García-Donas Jesus, Rini Brian I, Guchelaar Henk-Jan
Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333ZA, Netherlands.
Dutch SUTOX consortium, Leiden, Netherlands.
Eur J Clin Pharmacol. 2015 Dec;71(12):1477-84. doi: 10.1007/s00228-015-1935-7. Epub 2015 Sep 21.
Earlier, the association of single nucleotide polymorphisms (SNPs) with toxicity and efficacy of sunitinib has been explored in patients with metastatic renal cell carcinoma (mRCC). Recently, additional SNPs have been suggested as potential biomarkers. We investigated these novel SNPs for association with sunitinib treatment outcome in mRCC patients.
In this exploratory study, we selected SNPs in genes CYP3A4, NR1I2, POR, IL8, IL13, IL4-R, HIF1A and MET that might possibly be associated with sunitinib treatment outcome. Each SNP was tested for association with progression-free survival (PFS) and overall survival (OS) by Cox-regression analysis and for clinical response and toxicity using logistic regression.
We included 374 patients for toxicity analyses, of which 38 patients with non-clear cell renal cell cancer were excluded from efficacy analyses. The risk for hypertension was increased in the presence of the T allele in IL8 rs1126647 (OR = 1.69, 95 % CI = 1.07-2.67, P = 0.024). The T allele in IL13 rs1800925 was associated with an increase in the risk of leukopenia (OR = 6.76, 95 % CI = 1.35-33.9, P = 0.020) and increased prevalence of any toxicity > grade 2 (OR = 1.75, 95 % CI = 1.06-2.88, P = 0.028). No significant associations were found with PFS, OS or clinical response.
We show that polymorphisms in IL8 rs1126647 and IL13 rs1800925 are associated with sunitinib-induced toxicities. Validation in an independent cohort is required.
此前,已在转移性肾细胞癌(mRCC)患者中探索了单核苷酸多态性(SNP)与舒尼替尼毒性及疗效的关联。最近,有更多SNP被认为是潜在的生物标志物。我们研究了这些新型SNP与mRCC患者舒尼替尼治疗结局的关联。
在这项探索性研究中,我们在可能与舒尼替尼治疗结局相关的CYP3A4、NR1I2、POR、IL8、IL13、IL4-R、HIF1A和MET基因中选择了SNP。通过Cox回归分析测试每个SNP与无进展生存期(PFS)和总生存期(OS)的关联,并使用逻辑回归分析其与临床反应和毒性的关联。
我们纳入了374例患者进行毒性分析,其中38例非透明细胞肾细胞癌患者被排除在疗效分析之外。IL8 rs1126647中T等位基因的存在会增加高血压风险(OR = 1.69,95%CI = 1.07 - 2.67,P = 0.024)。IL13 rs1800925中的T等位基因与白细胞减少风险增加相关(OR = 6.76,95%CI = 1.35 - 33.9,P = 0.020),且与任何2级以上毒性的患病率增加相关(OR = 1.75,95%CI = 1.06 - 2.88,P = 0.028)。未发现与PFS、OS或临床反应有显著关联。
我们表明,IL8 rs1126647和IL13 rs1800925中的多态性与舒尼替尼诱导的毒性相关。需要在独立队列中进行验证。