Department of Drug Discovery and Development, Harrison College of Pharmacy, Auburn University, Auburn, Alabama, USA.
Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, Ohio, USA.
Cancer Rep (Hoboken). 2023 Sep;6 Suppl 1(Suppl 1):e1830. doi: 10.1002/cnr2.1830. Epub 2023 May 7.
Choosing the most effective chemotherapeutic agent with safest side effect profile is a common challenge in cancer treatment. Although there are standardized chemotherapy protocols in place, protocol changes made after extensive clinical trials demonstrate significant improvement in the efficacy and tolerability of certain drugs. The pharmacokinetics, pharmacodynamics, and tolerance of anti-cancer medications are all highly individualized. A driving force behind these differences lies within a person's genetic makeup.
Pharmacogenomics, the study of how an individual's genes impact the processing and action of a drug, can optimize drug responsiveness and reduce toxicities by creating a customized medication regimen. However, these differences are rarely considered in the initial determination of standardized chemotherapeutic protocols and treatment algorithms. Because pharmacoethnicity is influenced by both genetic and nongenetic variables, clinical data highlighting disparities in the frequency of polymorphisms between different ethnicities is steadily growing. Recent data suggests that ethnic variations in the expression of allelic variants may result in different pharmacokinetic properties of the anti-cancer medication. In this article, the clinical outcomes of various chemotherapy classes in patients of different ethnicities were reviewed.
Genetic and nongenetic variables contribute to the interindividual variability in response to chemotherapeutic drugs. Considering pharmacoethnicity in the initial determination of standard chemotherapeutic protocols and treatment algorithms can lead to better clinical outcomes of patients of different ethnicities.
在癌症治疗中，选择最有效且副作用最小的化疗药物是一个常见的挑战。虽然有标准化的化疗方案，但在广泛的临床试验后进行的方案更改表明，某些药物的疗效和耐受性有了显著提高。抗癌药物的药代动力学、药效学和耐受性都是高度个体化的。这些差异的驱动力在于一个人的基因构成。
药物基因组学是研究个体基因如何影响药物的处理和作用，通过创建定制的药物治疗方案，可以优化药物反应性并降低毒性。然而，在最初确定标准化化疗方案和治疗算法时，这些差异很少被考虑。由于药物种族差异受遗传和非遗传因素的影响，因此越来越多的临床数据强调了不同种族之间多态性频率的差异。最近的数据表明，等位基因变体表达的种族差异可能导致抗癌药物的药代动力学特性不同。本文回顾了不同种族患者中各种化疗药物的临床结局。
遗传和非遗传因素导致了对化疗药物反应的个体间变异性。在最初确定标准化化疗方案和治疗算法时考虑药物种族差异，可以改善不同种族患者的临床结局。
