Katayanagi Sou, Katsumata Kenji, Mori Yasuharu, Narahara Katsunori, Shigoka Masatoshi, Matsudo Takaaki, Enomoto Masanori, Suda Takeshi, Ishizaki Tetsuo, Hisada Masayuki, Nagakawa Yuuichi, Tsuchida Akihiko
Department of Digestive and Pediatric Surgery, Tokyo Medical University Hospital, Tokyo 160-0023, Japan.
Oncol Lett. 2019 Mar;17(3):2897-2904. doi: 10.3892/ol.2019.9907. Epub 2019 Jan 8.
Glutathione S-transferase (GST) exhibits antidotal effects on numerous drugs, including platinum-based antineoplastic drugs. Furthermore, () polymorphism is associated with peripheral neuropathy. In the present study, it was determined whether can predict adverse events associated with platinum-based antitumor agent-induced peripheral neuropathy among Japanese patients. The subjects included 122 patients, among whom 105 patients had colorectal, 16 had gastric, and one patient had pancreatic cancer. It was indicated that wild type (AA) was expressed in 99 patients (81.1%), whereas heterozygous (AG) and homozygous (GG) polymorphisms were present in 22 (18.0%) and 1 (0.8%) patients, respectively. Among patients with colorectal cancer, the expression of homozygous was observed in 88 patients (83.8%), whereas that of heterozygous was observed in 17 patients (16.2%). Peripheral neuropathy of grade ≥3 occurred in 10 patients (9.5%) receiving mFOLFOX therapy (a biweekly cycle consisting of a 2-h infusion of 85 mg/m oxaliplatin and 200 mg/m leucovorin followed by a bolus administration of 400 mg/m 5-fluorouracil and a continuous 48-h infusion of 2,400 mg/m 5-fluorouracil) for colorectal cancer, which included 6 patients with the AA allele (6.8%) and 4 patients with the AG allele (23.5%). The number of peripheral neuropathy cases of grade ≥3 was increased among patients with the AG allele, compared with patients with the AA allele (P=0.032). In patients with gastric cancer, the AA and AG types of were expressed in 11 (68.8%) and 5 (31.2%) patients, respectively. Cisplatin, administered to patients with gastric cancer, did not induce peripheral neuropathy. The aforementioned indicated that genetic polymorphism is associated with peripheral neuropathy induced by oxaliplatin treatment for colorectal cancer, and therefore serves as a predictive marker. Furthermore, early dose reduction or drug withdrawal should be implemented depending on the severity of peripheral neuropathy as a potential method for reducing the number of patients discontinuing the drug, due to adverse events involving peripheral neuropathy.
谷胱甘肽S-转移酶(GST)对多种药物具有解毒作用,包括铂类抗肿瘤药物。此外,()多态性与周围神经病变有关。在本研究中,旨在确定()是否能够预测日本患者中铂类抗肿瘤药物诱导的周围神经病变相关的不良事件。研究对象包括122例患者,其中105例患有结直肠癌,16例患有胃癌,1例患有胰腺癌。结果表明,99例患者(81.1%)表达野生型(AA)(),而杂合子(AG)和纯合子(GG)()多态性分别存在于22例(18.0%)和1例(0.8%)患者中。在结直肠癌患者中,88例患者(83.8%)观察到纯合子()的表达,而17例患者(16.2%)观察到杂合子()的表达。接受mFOLFOX治疗(每两周一个周期,包括2小时输注85mg/m奥沙利铂和200mg/m亚叶酸钙,随后推注400mg/m 5-氟尿嘧啶并持续48小时输注2400mg/m 5-氟尿嘧啶)的结直肠癌患者中,1级及以上周围神经病变发生在10例患者(9.5%)中,其中包括6例AA等位基因患者(6.8%)和4例AG等位基因患者(23.5%)。与AA等位基因患者相比,AG等位基因患者中1级及以上周围神经病变病例数增加(P=0.032)。在胃癌患者中,分别有11例(68.8%)和5例(31.2%)患者表达AA型和AG型()。给予胃癌患者顺铂未诱导周围神经病变。上述结果表明,()基因多态性与奥沙利铂治疗结直肠癌诱导的周围神经病变有关,因此可作为预测标志物。此外,应根据周围神经病变的严重程度尽早进行剂量减少或停药,作为减少因周围神经病变不良事件而停药患者数量的潜在方法。