The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, the New Territories, Hong Kong SAR, China.
The Croucher Laboratory for Human Genomics, The Chinese University of Hong Kong, Hong Kong SAR, China.
BMC Cancer. 2021 May 18;21(1):570. doi: 10.1186/s12885-021-08268-8.
Adjuvant endocrine therapies are known to induce undesirable adverse effects such as vasomotor, vaginal and musculoskeletal symptoms among breast cancer patients. Drugs used in these therapies are often metabolised by cytochrome P450 (CYP) enzymes, in which their metabolising activities can be modified by single nucleotide polymorphisms (SNP) in CYP genes and CYP genotypes. This review aims to explore whether SNPs or genotypes of CYP are associated with the occurrence, frequency and severity of vasomotor, vaginal and musculoskeletal symptoms in breast cancer patients on adjuvant endocrine therapies.
A literature review was conducted using five electronic databases, resulting in the inclusion of 14 eligible studies, and their findings were presented narratively. Selected items from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist were used for critical appraisal of the reporting quality of the included studies.
Most of the included studies showed that SNPs or genotypes of CYP that modify its metabolising activity have no effect on the occurrence, frequency or severity of vasomotor symptoms, including hot flashes. One study showed no correlation of these genetic variations in CYP with musculoskeletal symptoms, and no data were available on the association between such genetic variations and vaginal symptoms.
Overall, genetic variations in CYP have no effect on the experience of hot flashes among breast cancer patients. We recommend exploration of the link between the active metabolites of chemotherapeutic drugs and the molecules shown to affect the occurrence or severity of hot flashes, and the establishment of the relationship between such genetic variations and patients' experience of musculoskeletal and vaginal symptoms. Subgroup analyses based on patients' duration of adjuvant endocrine therapies in such studies are recommended.
辅助内分泌治疗已知会引起乳腺癌患者不良的不良反应，如血管舒缩、阴道和肌肉骨骼症状。这些治疗中使用的药物通常由细胞色素 P450（CYP）酶代谢，其代谢活性可以通过 CYP 基因和 CYP 基因型中的单核苷酸多态性（SNP）改变。本综述旨在探讨 CYP 的 SNP 或基因型是否与接受辅助内分泌治疗的乳腺癌患者血管舒缩、阴道和肌肉骨骼症状的发生、频率和严重程度有关。
通过五个电子数据库进行文献回顾，共纳入 14 项符合条件的研究，并进行叙述性呈现。从观察性研究的报告质量强化（STROBE）清单中选择了一些项目，用于对纳入研究的报告质量进行批判性评估。
大多数纳入的研究表明，改变 CYP 代谢活性的 CYP SNP 或基因型对血管舒缩症状（包括热潮红）的发生、频率或严重程度没有影响。一项研究表明，CYP 中的这些遗传变异与肌肉骨骼症状之间没有相关性，也没有关于这些遗传变异与阴道症状之间关联的数据。
总体而言，CYP 的遗传变异对乳腺癌患者出现热潮红没有影响。我们建议探讨化疗药物的活性代谢物与已知影响热潮红发生或严重程度的分子之间的联系，并建立这些遗传变异与患者肌肉骨骼和阴道症状体验之间的关系。建议在这些研究中基于患者辅助内分泌治疗的持续时间进行亚组分析。
