Gender-dependent association of TYMS-TSER polymorphism with 5-fluorouracil or capecitabine-based chemotherapy toxicity

Pharmacogenomics. 2021 Jul;22(11):669-680. doi: 10.2217/pgs-2021-0031. Epub 2021 Jun 8.

Abstract

Aim:TYMS gene encodes for TS enzyme involved in 5-fluorouracil (5-FU) and capecitabine (CAP) metabolism. This study assessed the association of TYMS-TSER and 3RG>C polymorphisms with 5-FU/CAP adverse event (AE) incidence. Materials & methods:TYMS-TSER and 3RG>C polymorphisms were analyzed by use of PCR/PCR-RFLP in 313 5-FU/CAP-treated cancer patients. Results: Female TYMS-TSER 2R carriers were at increased risk for 5-FU/CAP AEs (odds ratio: 2.195; p = 0.032). 2R/2R genotype was the only factor that increased risk for delayed drug administration or therapy discontinuation (odds ratio: 5.049; p = 0.016). No other associations were found. Conclusion:TYMS-TSER 3R/2R polymorphism was associated with incidence of AEs in female cancer patients. This gender-driven association potentially implicates the ER that, in female patients, potentially regulates TS expression.

Keywords: 5-fluorouracil; TYMS gene polymorphisms; adverse drug reactions; capecitabine; chemotherapy; fluoropyrimidines; pharmacogenomics; thymidylate synthase.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antimetabolites, Antineoplastic / administration & dosage*
  • Antimetabolites, Antineoplastic / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Capecitabine / administration & dosage*
  • Capecitabine / adverse effects
  • Female
  • Fluorouracil / administration & dosage*
  • Fluorouracil / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / drug therapy
  • Neoplasms / genetics
  • Polymorphism, Genetic / genetics*
  • Sex Characteristics*
  • Thymidylate Synthase / genetics*

Substances

  • Antimetabolites, Antineoplastic
  • Capecitabine
  • TYMS protein, human
  • Thymidylate Synthase
  • Fluorouracil