Association between the genetic polymorphisms of the pharmacokinetics of anthracycline drug and myelosuppression in a patient with breast cancer with anthracycline-based chemotherapy

Life Sci. 2021 Jul 1:276:119392. doi: 10.1016/j.lfs.2021.119392. Epub 2021 Mar 24.

Abstract

Aims: Exploring the genetic polymorphisms involved in the metabolism of anthracyclines can explain the causes of individual differences in myelosuppression during anthracycline-based chemotherapy.

Main methods: By PCR and Sanger sequencing, SNP of candidate genes participating into the pharmacokinetics of anthracycline, including chemotherapeutic drug intake (SLC22A16 rs6907567), metabolism (AKR1A1 rs2088102, CBR1 rs20572) and transfer (ABCG2 rs2231142) are detected in 194 breast cancer patients undergoing anthracycline-based postoperative adjuvant chemotherapy.

Key findings: The CBR1 rs20572 (C>T) polymorphic allele, the ABCG2 rs2231142 (G>T) polymorphic allele, or the two polymorphic allele in combination significantly reduced the risk of leukopenia (OR 0.412, 95% CI 0.187-0.905, p = 0.025) and neutropenia (OR 0.354, 95% CI 0.148-0.846, p = 0.018). Either polymorphic allele T of CBR1 rs20572, or polymorphic allele C of AKR1A1 rs2088102 combined with the presence of both ABCG2 rs2231142(G>T) and SLC22A16 rs6907567(A>G) mutations were at extremely low risk of severe anemia of grades 3 and 4 (OR 0.058, 95% CI 0.006-0.554, p = 0.008, OR 0.065, 95% CI 0.006-0.689, p = 0.022, OR 0.037, 95% CI 0.004-0.36, p = 0.015, respectively).

Significance: These results suggested CBR1 rs20572, ABCG2 rs2231142, SLC22A16 rs6907567 and AKR1A1 rs2088102 might be potential protective factors for the reduction of hematologic toxicity incidence during anthracycline-based chemotherapy in breast cancer patients.

Keywords: Anthracyclines; Breast cancer; Hematologic toxicity; Single nucleotide polymorphism.

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily G, Member 2 / genetics
  • Adult
  • Alcohol Oxidoreductases / genetics
  • Aldehyde Reductase / genetics
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / pharmacokinetics*
  • Biomarkers, Tumor / genetics*
  • Bone Marrow Diseases / chemically induced
  • Bone Marrow Diseases / epidemiology*
  • Bone Marrow Diseases / pathology
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / genetics
  • Breast Neoplasms / pathology
  • China / epidemiology
  • Cyclophosphamide / administration & dosage
  • Doxorubicin / administration & dosage
  • Female
  • Follow-Up Studies
  • Gene Expression Regulation, Neoplastic / drug effects*
  • Genetic Predisposition to Disease
  • Humans
  • Middle Aged
  • Neoplasm Proteins / genetics
  • Organic Cation Transport Proteins / genetics
  • Polymorphism, Single Nucleotide*
  • Prognosis
  • Receptor, ErbB-2 / metabolism
  • Receptors, Estrogen / metabolism
  • Receptors, Progesterone / metabolism
  • Survival Rate
  • Tissue Distribution

Substances

  • ABCG2 protein, human
  • ATP Binding Cassette Transporter, Subfamily G, Member 2
  • Biomarkers, Tumor
  • Neoplasm Proteins
  • Organic Cation Transport Proteins
  • Receptors, Estrogen
  • Receptors, Progesterone
  • SLC22A16 protein, human
  • Doxorubicin
  • Cyclophosphamide
  • Alcohol Oxidoreductases
  • CBR1 protein, human
  • AKR1A1 protein, human
  • Aldehyde Reductase
  • ERBB2 protein, human
  • Receptor, ErbB-2