Department of Clinical and Molecular Medicine, Oncology Unit, Sant' Andrea Hospital, University "La Sapienza", 00167 Rome, Italy.
Department of Medical-Surgical Sciences and Translation Medicine, Sant' Andrea Hospital, University "La Sapienza", 00167 Rome, Italy.
Curr Oncol. 2021 May 25;28(3):1980-1987. doi: 10.3390/curroncol28030184.
Personalized therapy is becoming increasingly popular in oncological scenarios, not only based on molecular pharmacological targets, but also preventing any drug-drug-gene interaction (DDGI), which could lead to severe toxicities. Single nucleotide polymorphisms (SNPs), the individual germline sequence variations in genes involved in drug metabolism, are correlated to interindividual response to drugs and explain both efficacy and toxicity profiles reported by patients.
We present the case of a woman suffering from triple-positive breast cancer; she had early-stage disease at the onset and after four years developed metastatic disease. During her history, she presented different toxicities due to antineoplastic treatments. Particularly, hypertransaminasemia was found during every line of treatment. Nevertheless, we were able to guarantee the patient an excellent therapeutic adhesion thanks to the supportive treatments and the reduction of drug dosage. Moreover, we conducted a simultaneous analysis of the patient's biochemical and genomic data thanks to Drug-PIN software, and we found several significant SNPs of the main enzymes and transporters involved in drug metabolism.
Our case report demonstrated the relevance of DDGI in clinical practice management of a patient treated for advanced breast cancer, suggesting the role of Drug-PIN software as an easy-to-use tool to prevent adverse events during cancer treatment and to help physicians in therapeutic algorithms. However, further studies are needed to confirm these results.
个性化治疗在肿瘤学领域越来越受欢迎，不仅基于分子药理学靶点，还预防任何药物-药物-基因相互作用（DDGI），这可能导致严重的毒性。单核苷酸多态性（SNP）是参与药物代谢的基因中个体种系序列的变化，与个体对药物的反应相关，并解释了患者报告的疗效和毒性特征。
我们介绍了一位患有三阳性乳腺癌的女性患者；她在发病时处于早期阶段，四年后发展为转移性疾病。在她的病史中，由于抗肿瘤治疗，她出现了不同的毒性。特别是，在每一行治疗中都发现了高氨基转移酶血症。然而，我们能够通过支持性治疗和减少药物剂量来保证患者的治疗良好的依从性。此外，我们还通过 Drug-PIN 软件对患者的生化和基因组数据进行了同时分析，发现了几个主要参与药物代谢的酶和转运体的重要 SNP。
我们的病例报告表明 DDGI 在晚期乳腺癌患者的临床实践管理中的重要性，提示 Drug-PIN 软件作为一种易于使用的工具，可预防癌症治疗期间的不良事件，并帮助医生制定治疗算法。然而，需要进一步的研究来证实这些结果。
