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Prediction of irino...
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Glimelius, BengtUppsala universitet,Enheten för onkologi
(author)
Prediction of irinotecan and 5-fluorouracil toxicity and response in patients with advanced colorectal cancer
- Article/chapterEnglish2011
Publisher, publication year, extent ...
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2010-02-23
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Springer Science and Business Media LLC,2011
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-124681
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-124681URI
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https://doi.org/10.1038/tpj.2010.10DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:121905573URI
Supplementary language notes
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Language:English
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Summary in:English
Part of subdatabase
Classification
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Irinotecan and 5-fluorouracil (5-FU) are used to treat metastatic colorectal cancer. Irinotecan's active metabolite is inactivated by UDP-glucuronosyltransferase 1A1 (UGT1A1), which is deficient in Gilbert's syndrome. Irinotecan and metabolites are transported by P-glycoprotein, encoded by ABCB1. 5-FU targets folate metabolism through inhibition of thymidylate synthase (TYMS). Methylenetetrahydrofolate reductase (MTHFR) generates active folate necessary for haematopoiesis. We retrospectively genotyped 140 Swedish and Norwegian irinotecan and 5-FU-treated colorectal cancer patients from the Nordic VI clinical trial for selected variants of UGT1A1, ABCB1, TYMS and MTHFR. We found an increased risk of clinically relevant early toxicity in patients carrying the ABCB1 3435 T/T genotype, Odds ratio (OR)=3.79 (95% confidence interval (CI)=1.09-13.2), and in patients carrying the UGT1A1(*)28/(*)28 genotype, OR=4.43 (95% CI=1.30-15.2). Patients with UGT1A1(*)28/(*)28 had an especially high risk of neutropenia, OR=6.87 (95% CI=1.70-27.7). Patients who had reacted with toxicity during the first two cycles were in total treated with fewer cycles (P<0.001), and less often responded to treatment (P<0.001). Genetic variation in ABCB1 was associated with both early toxicity and lower response to treatment. Carriers of the ABCB1 1236T-2677T-3435T haplotype responded to treatment less frequently (43 vs 67%, P=0.027), and survived shorter time, OR=1.56 (95% CI=1.01-2.45).
Subject headings and genre
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camptothecin/analogs and derivatives
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fluorouracil
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glucuronosyltransferase
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methylenetetrahydrofolate reductase (NADPH2)
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P-glycoprotein
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thymidylate synthase
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MEDICINE
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MEDICIN
Added entries (persons, corporate bodies, meetings, titles ...)
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Garmo, HansRegional Oncologic Centre, Uppsala University Hospital
(author)
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Berglund, ÅkeUppsala universitet,Enheten för onkologi(Swepub:uu)akebergl
(author)
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Fredriksson, L. A.Uppsala universitet,Klinisk farmakogenomik och osteoporos
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Berglund, MattiasUppsala universitet,Enheten för onkologi(Swepub:uu)mattiber
(author)
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Kohnke, HugoUppsala universitet,Klinisk farmakologi(Swepub:uu)hukoh103
(author)
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Byström, P.
(author)
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Sørbye, H.
(author)
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Wadelius, MiaUppsala universitet,Klinisk farmakogenomik och osteoporos,Klinisk Farmakologi (Clinical Pharmacogenetics)(Swepub:uu)miawadel
(author)
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Uppsala universitetEnheten för onkologi
(creator_code:org_t)
Related titles
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In:The Pharmacogenomics Journal: Springer Science and Business Media LLC11:1, s. 61-711470-269X1473-1150
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