University of Minnesota, Division of Gynecologic Oncology, Minneapolis, MN, United States of America.
University of Southern California, Center for Genetic Epidemiology, Keck School of Medicine, Los Angeles, CA, United States of America.
Gynecol Oncol. 2021 Dec;163(3):578-582. doi: 10.1016/j.ygyno.2021.10.006. Epub 2021 Oct 18.
To identify genetic variants associated with chemotherapy-induced peripheral neuropathy (CIPN) symptoms among gynecologic cancer survivors and determine the variants' predictive power in addition to age and clinical factors at time of diagnosis.
Participants of a prospective cohort study on gynecologic cancers provided a DNA saliva sample and reported CIPN symptoms (FACT/GOG-Ntx). Genotyping of 23 single nucleotide polymorphisms (SNPs) previously identified as related to platinum- or taxane-induced neuropathy was performed using iPLEX Gold method. Risk allele carrier frequencies of 19 SNPs that passed quality checks were compared between those with/without high CIPN symptoms using logistic regression, adjusting for age. Receiver operating characteristic (ROC) curves using clinical risk factors (age, diabetes, BMI, Charlson Comorbidity Index, previous cancer diagnosis) with and without the identified SNPs were compared.
107 individuals received platinum or taxane-based chemotherapy and provided sufficient DNA for analysis. Median age was 65.1 years; 39.6% had obesity and 8.4% diabetes; most had ovarian (58.9%) or uterine cancer (29.0%). Two SNPs were significantly associated with high CIPN symptomatology: rs3753753 in GPX7, OR = 2.55 (1.13, 5.72) and rs139887 in SOX10, 2.66 (1.18, 6.00). Including these two SNPs in a model with clinical characteristics led to an improved AUC for CIPN symptomatology (0.65 vs. 0.74, p = 0.04).
Genetic and clinical characteristics were predictive of higher CIPN symptomatology in gynecologic cancer survivors, and combining these factors resulted in superior predictive power compared with a model with clinical factors only. Prospective validation and assessment of clinical utility are warranted.
确定与妇科癌症幸存者化疗引起的周围神经病变(CIPN)症状相关的遗传变异,并确定这些变异在诊断时的年龄和临床因素之外的预测能力。
参加妇科癌症前瞻性队列研究的参与者提供了一份 DNA 唾液样本,并报告了 CIPN 症状(FACT/GOG-Ntx)。使用 iPLEX Gold 方法对先前确定与铂类或紫杉烷类诱导的神经病相关的 23 个单核苷酸多态性(SNP)进行基因分型。使用逻辑回归比较通过质量检查的 19 个 SNP 的风险等位基因携带者频率,根据年龄进行调整,比较高 CIPN 症状患者与无高 CIPN 症状患者之间的差异。比较包含和不包含鉴定 SNP 的临床危险因素(年龄、糖尿病、BMI、Charlson 合并症指数、先前癌症诊断)的受试者工作特征(ROC)曲线。
107 名个体接受了铂类或紫杉烷类为基础的化疗,并提供了足够的 DNA 进行分析。中位年龄为 65.1 岁;39.6%的人肥胖,8.4%的人患有糖尿病;大多数患有卵巢癌(58.9%)或子宫癌(29.0%)。有两个 SNP 与高 CIPN 症状显著相关:GPX7 中的 rs3753753,OR=2.55(1.13, 5.72)和 SOX10 中的 rs139887,OR=2.66(1.18, 6.00)。在包含临床特征的模型中加入这两个 SNP 可改善 CIPN 症状的 AUC(0.65 与 0.74,p=0.04)。
遗传和临床特征可预测妇科癌症幸存者的 CIPN 症状更高,与仅包含临床因素的模型相比,结合这些因素可提高预测能力。需要进行前瞻性验证和临床实用性评估。