Interaction Between SNP Genotype and Efficacy of Anastrozole and Exemestane in Early-Stage Breast Cancer

Clin Pharmacol Ther. 2021 Oct;110(4):1038-1049. doi: 10.1002/cpt.2311. Epub 2021 Jun 21.

Abstract

Aromatase inhibitors (AIs) are the treatment of choice for hormone receptor-positive early breast cancer in postmenopausal women. None of the third-generation AIs are superior to the others in terms of efficacy. We attempted to identify genetic factors that could differentiate between the effectiveness of adjuvant anastrozole and exemestane by examining single-nucleotide polymorphism (SNP)-treatment interaction in 4,465 patients. A group of SNPs were found to be differentially associated between anastrozole and exemestane regarding outcomes. However, they showed no association with outcome in the combined analysis. We followed up common SNPs near LY75 and GPR160 that could differentiate anastrozole from exemestane efficacy. LY75 and GPR160 participate in epithelial-to-mesenchymal transition and growth pathways, in both cases with SNP-dependent variation in regulation. Collectively, these studies identified SNPs that differentiate the efficacy of anastrozole and exemestane and they suggest additional genetic biomarkers for possible use in selecting an AI for a given patient.

Publication types

  • Clinical Trial, Phase III
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anastrozole / therapeutic use*
  • Androstadienes / therapeutic use*
  • Antigens, CD / genetics
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Aromatase Inhibitors / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / genetics
  • Breast Neoplasms / pathology
  • Chemotherapy, Adjuvant
  • Epithelial-Mesenchymal Transition / genetics
  • Female
  • Humans
  • Lectins, C-Type / genetics
  • Minor Histocompatibility Antigens / genetics
  • Neoplasm Staging
  • Patient Selection
  • Pharmacogenomic Variants
  • Polymorphism, Single Nucleotide
  • Receptors, Cell Surface / genetics
  • Receptors, G-Protein-Coupled / genetics
  • Treatment Outcome

Substances

  • Androstadienes
  • Antigens, CD
  • Antineoplastic Agents, Hormonal
  • Aromatase Inhibitors
  • DEC-205 receptor
  • GPR160 protein, human
  • Lectins, C-Type
  • Minor Histocompatibility Antigens
  • Receptors, Cell Surface
  • Receptors, G-Protein-Coupled
  • Anastrozole
  • exemestane