Affiliation:
1. Russian Medical Academy of Continuous Professional Education; City Clinical Cancer Hospital No. 1
2. Russian Medical Academy of Continuous Professional Education; City Clinical Cancer Hospital No. 1; Novokuznetsk State Institute of Postgraduate Medical Education – branch of Russian Medical Academy of Continuous Professional Education
3. Russian Medical Academy of Continuous Professional Education
4. Engelhardt Institute of Molecular Biology, Russian Academy of Sciences
5. Russian Medical Academy of Continuous Professional Education; Novokuznetsk State Institute of Postgraduate Medical Education – branch of Russian Medical Academy of Continuous Professional Education
6. National Research Ogarev Mordovia State University
7. City Clinical Cancer Hospital No. 1
Abstract
Introdiction. Systemic chemotherapy (CT) based on oxaliplatin, 5-fluorouracil, capecitabine is the standard of treatment for advanced gastric, colorectal and rectal cancer, which is characterized by frequent development of severe adverse events (AEs). The results of translational studies in the Russian patient population are limited, it is necessary to study pharmacogenetic markers. Aim. To study the frequency of carrying allelic variants of DPYD, GSTP1, MTHFR, XPC, ERCC1, TYMS genes and their association with the development of AEs during palliative treatment with FOLFOX/XELOX.Materials and methods. A total of 166 patients (67 gastric cancer, 99 colorectal cancer) were included in the prospective observational study. All patients underwent pharmacogenetic testing by hybridization analysis on biological microarrays (DPYD (rs2297595 and rs75017182), MTHFR (rs1801133), XPC (rs2228001), TYMS (rs11280056), ERCC1 (rs3212986)) and PCR (GSTP1 (rs1695), ERCC1 (rs11615)) before starting CT. The genotype frequency distribution was analyzed between the groups of patients with and without the development of severe AEs.Results. AEs developed in 97.7% of patients, severe AEs accounting for 54.2%. According to the results of univariate analysis, TC genotype of DPYD gene rs2297595 OR = 3.0 (95% CI 1.2–7.3, p = 0.025), GG genotype of GSTP1 gene rs1695 OR = 2.9 (95% CI 1.02–8.6, p = 0.038) were associated with the development of severe neutropenia. In multivariate analysis TT genotype rs2297595 of the DPYD gene remained the only predictor of severe neutropenia (B ± SE = -1.103 ± 0.503; DI [-2.090; -0.116]; p = 0.028).Conclusions. The results of this study allowed us to identify possible markers of toxicity of FOLFOX/XELOX chemotherapy.
Reference25 articles.
1. Kaprin AD, Starinskii VV, Petrova GV (red.). Sostoyanie onkologicheskoi pomoshchi naseleniyu Rossii v 2018 godu. M.: MNIOI im. P.A. Gertsena – filial FGBU «NMITs radiologii» Minzdrava Rossii; 2019. 236 s. Rezhim dostupa: https://oncology-association.ru/wp-content/uploads/2020/09/sostoyanie_2018.pdf?ysclid=lnis28yzzl945263948.
2. Tournigand C, André T, Achille E, Lledo G, Flesh M, Mery-Mignar D et al. FOLFIRI Followed by FOLFOX6 or the Reverse Sequence in Advanced Colorectal Cancer: A Randomized GERCOR Study. J Clin Oncol. 2004;22(2):229–237. https://doi.org/10.1200/JCO.2004.05.113.
3. De Vita F, Orditura M, Matano E, Bianco R, Carlomagno C, Infusino S et al. A phase II study of biweekly oxaliplatin plus infusional 5-fluorouracil and folinic acid (FOLFOX-4) as first-line treatment of advanced gastric cancer patients. Br J Cancer. 2005;92(9):1644–1649. https://doi.org/10.1038/sj.bjc.6602573.
4. Onakpoya IJ, Heneghan CJ, Aronson JK. Worldwide withdrawal of medicinal products because of adverse drug reactions: a systematic review and analysis. Crit Rev Toxicol. 2016;46(6):477–489. https://doi.org/10.3109/10408444.2016.1149452.
5. Shahnam A, Ridha Z, Wiese MD, Kichenadasse G, Sorich MJ. Pharmacogenetic and ethnicity influence on oxaliplatin therapy for colorectal cancer: a meta-analysis. Pharmacogenomics. 2016;17(15):1725–1732. https://doi.org/10.2217/pgs-2016-0102.