Galeotti Laura, Ceccherini Francesco, Domingo Dario, Laurino Marco, Polillo Marialuisa, Di Paolo Antonello, Baratè Claudia, Fava Carmen, D'Avolio Antonio, Cervetti Giulia, Guerrini Francesca, Fontanelli Giulia, Ciabatti Elena, Grassi Susanna, Arrigoni Elena, Danesi Romano, Petrini Mario, Cornolti Fulvio, Saglio Giuseppe, Galimberti Sara
Phymtech Srl, Via Giuntini 63, Navacchio, 56023, Pisa, Italy.
Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, 56126, Pisa, Italy.
Cancer Chemother Pharmacol. 2017 Apr;79(4):767-773. doi: 10.1007/s00280-017-3271-3. Epub 2017 Mar 13.
The present study was aimed at investigating whether imatinib pharmacogenetics is related to its pharmacodynamics in patients affected by chronic myeloid leukemia.
Through a procedure based on a sequence of classical statistics methods, we investigated the possible relationships between treatment efficacy/tolerability and combinations of time-independent variables as gender and genetic covariates in the form of single nucleotide polymorphisms (SNPs) or combinations thereof. Moreover, since the drug tolerability has a strong incidence on the discontinuation of the therapy, we investigated whether the time of manifestation of the most frequent toxic effects can be related to time-independent patients' characteristics or not.
We found that a combination of two polymorphisms, namely hOCT1 c.480C>G (rs683369) and ABCB1 c.3435C>T (rs1045642), seems to play the role of predictor for imatinib in both efficacy and toxicity. Furthermore, the time of manifestation of edema toxicity is found to be associated to a combination of gender and ABCB1 c.3435C>T, whereas the time of manifestation of cramp toxicity appears related to gender.
The novelty of this study is dual: the achievement of results that potentially have a significant clinical interest and the demonstration that the adoption of composed covariates may represent a unique tool to study different aspects of the treatment with imatinib.
本研究旨在调查伊马替尼药物遗传学是否与其在慢性髓性白血病患者中的药效学相关。
通过基于一系列经典统计方法的程序,我们研究了治疗效果/耐受性与性别等时间独立变量以及单核苷酸多态性(SNP)形式的基因协变量或其组合之间的可能关系。此外,由于药物耐受性对治疗中断有很大影响,我们研究了最常见毒性作用的表现时间是否与患者的时间独立特征相关。
我们发现两种多态性的组合,即hOCT1 c.480C>G(rs683369)和ABCB1 c.3435C>T(rs1045642),似乎在伊马替尼的疗效和毒性方面都起到了预测作用。此外,发现水肿毒性的表现时间与性别和ABCB1 c.3435C>T的组合有关,而痉挛毒性的表现时间似乎与性别有关。
本研究的新颖之处在于双重:取得了可能具有重大临床意义的结果,并证明采用组合协变量可能是研究伊马替尼治疗不同方面的独特工具。