与卡培他滨严重毒性相关的新单核苷酸多态性的鉴定。
Identification of new SNPs associated with severe toxicity to capecitabine.
作者信息
Pellicer Marta, García-González Xandra, García María I, Robles Luis, Grávalos Cristina, García-Alfonso Pilar, Pachón Vanessa, Longo Federico, Martínez Virginia, Blanco Carolina, Iglesias Irene, Sanjurjo María, López-Fernández Luis A
机构信息
Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
Hospital Universitario Doce de Octubre, Instituto de Investigación Sanitaria Hospital Doce de Octubre, Madrid, Spain.
出版信息
Pharmacol Res. 2017 Jun;120:133-137. doi: 10.1016/j.phrs.2017.03.021. Epub 2017 Mar 27.
Predicting individual risk of chemotherapy-induced severe adverse reaction is a critical issue when selecting the best treatment for cancer patients. SNPs have been identified in genes involved in the pharmacodynamics of fluoropyrimidines, and guidelines even recommend genotyping some DPYD variants in order to estimate the risk of toxicity. However, the predictive value of this approach remains insufficient, thus limiting its clinical implementation. The aim of the present study was to identify new genetic variants by selecting a group of tag SNPs in genes associated with the pharmacodynamics of fluoropyrimidines (CDA, DPYD, ENOSF1, CES1, TYMS, SLC22A7, TYMP, and UMPS). For this purpose, 23 selected SNPs were genotyped on an OpenArray™ platform in a cohort of 301 colorectal cancer patients receiving capecitabine-based chemotherapy. Univariate and multivariate statistical analysis by logistic regression revealed 10 SNPs associated with severe adverse reactions to capecitabine (P<0.05): rs1048977, rs12726436, and rs2072671 in CDA; rs12119882 in DPYD; rs2853741 in TYMS; rs699517 in TYMS/ENOSF1; rs2270860 and rs4149178 in SLC22A7; and rs2279199 and rs4678145 in UMPS. Except for rs2072671, no association had previously been reported between these SNPs and the risk of capecitabine-induced toxicity. The use of tag SNPs to find new polymorphisms related to adverse reactions to capecitabine was successful. These new variants could increase the predictive power of currently available tests and thus prevent severe adverse reactions to capecitabine.
预测个体化疗诱导的严重不良反应风险是为癌症患者选择最佳治疗方案时的关键问题。已在参与氟嘧啶药效学的基因中鉴定出单核苷酸多态性(SNP),甚至指南也建议对某些二氢嘧啶脱氢酶(DPYD)变体进行基因分型,以评估毒性风险。然而,这种方法的预测价值仍然不足,从而限制了其临床应用。本研究的目的是通过在与氟嘧啶药效学相关的基因(胞苷脱氨酶(CDA)、DPYD、ENOSF1、羧酸酯酶1(CES1)、胸苷酸合成酶(TYMS)、溶质载体家族22成员7(SLC22A7)、胸苷磷酸化酶(TYMP)和尿苷单磷酸合成酶(UMPS))中选择一组标签SNP来鉴定新的基因变体。为此,在一个接受卡培他滨化疗的301例结直肠癌患者队列中,在OpenArray™平台上对23个选定的SNP进行了基因分型。通过逻辑回归进行的单变量和多变量统计分析揭示了10个与卡培他滨严重不良反应相关的SNP(P<0.05):CDA中的rs1048977、rs12726436和rs2072671;DPYD中的rs12119882;TYMS中的rs2853741;TYMS/ENOSF1中的rs699517;SLC22A7中的rs2270860和rs4149178;UMPS中的rs2279199和rs4678145。除rsz072671外,此前未报道这些SNP与卡培他滨诱导的毒性风险之间存在关联。使用标签SNP来发现与卡培他滨不良反应相关的新多态性是成功的。这些新变体可以提高现有检测的预测能力,从而预防卡培他滨引起的严重不良反应。