Genetic variations in ABC transporter genes as a predictive biomarker for toxicity in North Indian lung cancer patients undergoing platinum-based doublet chemotherapy

J Biochem Mol Toxicol. 2023 Mar;37(3):e23269. doi: 10.1002/jbt.23269. Epub 2022 Dec 11.

Abstract

ATP-binding cassette (ABC) transporters are expressed in various human tissues and play a vital role in the efflux of various chemotherapeutic drugs. The current study has assessed genetic variants of ABCB1, ABCC1, ABCC2, and ABCG2 genes in 407 lung cancer patients undergoing platinum-based doublet chemotherapy. The association of ABCB1 (C1236 T, C3435 T, and G2677 T/A), ABCC1 (G3173 A and G2168 A),ABCC2 (G4544 A), and ABCG2 (C421 A) polymorphisms with chemotherapy-induced adverse events were assessed, and statistical analysis was conducted. Our data showed that patients harboring heterozygous (GA) genotype for ABCC1 G3173 A had an increased risk of developing leukopenia (odds ratio [OR] = 1.88, p = 0.04) and anemia (adjusted odds ratio [AOR] = 2.70, p = 0.03). For ABCC2 G4544 A polymorphism, patients harboring one copy of the mutant (GA) allele showed an increased risk of developing anemia (OR = 4.24, p = 0.03). After adjusting with various confounding factors, the heterozygous (GA) genotype showed a 5.63-fold increased risk of developing anemia (AOR = 5.63, p = 0.03). The ABCB1 G2677 A (OR = 0.37, p = 0.008) and ABCC1 G3173 A (OR = 0.54, p = 0.04) polymorphism showed a lower incidence of developing nephrotoxicity. In ABCG2 C421 A polymorphism, patients harboring heterozygous (CA) genotype had a lower incidence of having diarrhea (OR = 0.25, p = 0.04). An increased risk of having diarrhea was observed in the heterozygous genotype (GA) for ABCC1 G3173 A polymorphism (AOR = 2.78, p = 0.04). An increased risk of liver injury was found in the patients carrying heterozygous genotype of the ABCC1 G3173 A (OR = 2.06, p = 0.02) and ABCB1 C1236 T (OR = 1.85, p = 0.01). This study demonstrates the role of polymorphic variations in ABCB1, ABCC1, ABCC2, and ABCG2 in predicting hematological, nephrotoxicity, gastrointestinal, and hepatotoxicity.

Keywords: ABC transporter; lung cancer; polymorphism; risk; toxicity.

MeSH terms

  • ATP-Binding Cassette Transporters* / genetics
  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia / chemically induced
  • Anemia / genetics
  • Antineoplastic Combined Chemotherapy Protocols* / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Carboplatin* / administration & dosage
  • Carboplatin* / adverse effects
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Chemical and Drug Induced Liver Injury / etiology
  • Chemical and Drug Induced Liver Injury / genetics
  • Cisplatin* / administration & dosage
  • Cisplatin* / adverse effects
  • Diarrhea / chemically induced
  • Diarrhea / genetics
  • Docetaxel / administration & dosage
  • Docetaxel / adverse effects
  • Etoposide / administration & dosage
  • Etoposide / adverse effects
  • Female
  • Gefitinib / administration & dosage
  • Gefitinib / adverse effects
  • Gemcitabine / administration & dosage
  • Gemcitabine / adverse effects
  • Genotype
  • Humans
  • India
  • Irinotecan / administration & dosage
  • Irinotecan / adverse effects
  • Kidney Diseases / chemically induced
  • Kidney Diseases / genetics
  • Leukopenia / chemically induced
  • Leukopenia / genetics
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / genetics
  • Lung Neoplasms* / pathology
  • Male
  • Middle Aged
  • Paclitaxel / administration & dosage
  • Paclitaxel / adverse effects
  • Pemetrexed / administration & dosage
  • Pemetrexed / adverse effects
  • Polymorphism, Genetic
  • Small Cell Lung Carcinoma / drug therapy
  • Small Cell Lung Carcinoma / genetics
  • Small Cell Lung Carcinoma / pathology
  • South Asian People* / genetics

Substances

  • ABCB1 protein, human
  • ABCC2 protein, human
  • ABCG2 protein, human
  • ATP-Binding Cassette Transporters
  • Carboplatin
  • Cisplatin
  • Docetaxel
  • Etoposide
  • Gefitinib
  • Gemcitabine
  • Irinotecan
  • multidrug resistance-associated protein 1
  • Paclitaxel
  • Pemetrexed