An update on ethnic differences in drug metabolism and toxicity from anti-cancer drugs

Expert Opin Drug Metab Toxicol. 2011 Nov;7(11):1395-410. doi: 10.1517/17425255.2011.624513. Epub 2011 Sep 28.

Abstract

Introduction: Based on recent emerging evidence of inter-ethnic differences in drug response and toxicity, ethnic diversity in pharmacokinetics, pharmacogenomics and clinical outcomes are being increasingly investigated. Ultimately, this will promote improved understanding of inter-individual differences in the pharmacokinetics and tolerance of cytotoxic drugs.

Areas covered: This article reviews potential explanations for the observed ethnic differences in treatment outcomes and provides clinical data to support this concept. A literature search was implemented on PubMed and PharmGKB to investigate the areas of ethnic differences in pharmacogenomics, pharmacogenetics and clinical outcomes of cancer therapies.

Expert opinion: There has been a relative paucity of clinical evidence linking genetic polymorphisms of genes encoding drug-metabolizing enzymes to the pharmacokinetics, pharmacodynamics and tolerance of anti-cancer drugs. Future research should focus on studies using large sample sizes, in the hope that they will provide results of high clinical significance. Due to the potential for ethnic differences to impact on both toxicities and benefits of systemic cancer therapies, the development of new therapeutic agents should include patients from diverse geographical ancestries in each phase of drug development.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / metabolism*
  • Antineoplastic Agents / pharmacokinetics
  • Antineoplastic Agents / therapeutic use
  • Humans
  • Inactivation, Metabolic / ethnology
  • Inactivation, Metabolic / genetics*
  • Pharmaceutical Preparations / metabolism*
  • Pharmacogenetics*
  • Polymorphism, Genetic*
  • Precision Medicine
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Pharmaceutical Preparations