Pharmacogenomics of Vincristine-Induced Peripheral Neuropathy Implicates Pharmacokinetic and Inherited Neuropathy Genes

Clin Pharmacol Ther. 2019 Feb;105(2):402-410. doi: 10.1002/cpt.1179. Epub 2018 Aug 17.

Abstract

Vincristine is an effective chemotherapeutic drug for various cancers, including acute lymphoblastic leukemia (ALL). Unfortunately, clinical utility is restricted by dose-limiting vincristine-induced peripheral neuropathies (VIPN). We sought to determine the association of VIPN with a recently identified risk variant, CEP72 rs924607, and drug absorption, distribution, metabolism, and excretion (ADME) gene variants in pediatric ALL. This was followed by a meta-analysis of pharmacogenomic data from over 500 patients. CEP72 rs924607 was significantly associated with VIPN (P = 0.02; odds ratio (OR) = 3.4). ADME analyses identified associations between VIPN and ABCC1 rs3784867 (P = 5.34 × 10-5 ; OR = 4.9), and SLC5A7 rs1013940 (P = 9.00 × 10-4 ; OR= 8.6); genes involved in vincristine transport and inherited neuropathies, respectively. Meta-analysis identified an association with a variant related to TTPA (rs10504361: P = 6.85 × 10-4 ; OR = 2.0), a heritable neuropathy-related gene. This study provides essential corroboratory evidence for CEP72 rs924607 and highlights the importance of drug transporter and inherited neuropathy genes in VIPN.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents, Phytogenic / pharmacokinetics*
  • Antineoplastic Agents, Phytogenic / toxicity*
  • Child
  • Child, Preschool
  • Computational Biology
  • Female
  • Humans
  • Male
  • Microtubule-Associated Proteins / genetics
  • Multidrug Resistance-Associated Proteins / genetics
  • Peripheral Nervous System Diseases / chemically induced*
  • Peripheral Nervous System Diseases / genetics*
  • Pharmacogenetics
  • Tissue Distribution
  • Vincristine / pharmacokinetics*
  • Vincristine / toxicity*

Substances

  • Antineoplastic Agents, Phytogenic
  • CEP72 protein, human
  • Microtubule-Associated Proteins
  • Multidrug Resistance-Associated Proteins
  • Vincristine
  • multidrug resistance-associated protein 1