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Díaz-Santa J, Rodríguez-Romanos R, Coll R, Osca G, Pratcorona M, González-Bartulos M, Garrido A, Angona A, Talarn C, Tormo M, Arnan M, Vives S, Salamero O, Tuset E, Lloveras N, Díez I, Zamora L, Bargay J, Sampol A, Cruz D, Vila J, Sitges M, Garcia A, Vall-Llovera F, Esteve J, Sierra J, Gallardo D. 5'-nucleotidase, cytosolic ii genotype and clinical outcome in patients with acute myeloid leukemia with intermediate-risk cytogenetics. Eur J Haematol Suppl 2022; 109:755-764. [PMID: 36063368 DOI: 10.1111/ejh.13862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/29/2022] [Accepted: 09/01/2022] [Indexed: 11/26/2022]
Abstract
Acute myeloid leukemia (AML) is a complex disease, and its treatment needs to be adjusted to the risk, which is conferred by cytogenetics and molecular markers. Cytarabine is the main drug to treat AML, and it has been suggested that the genotype of cytarabine metabolizing enzymes may have a prognostic relevance in AML. Here we report the association between the 5'-nucleotidase, cytosolic II (NT5C2) rs10883841, cytidine deaminase (CDA) rs2072671 and rs532545 genotypes and the clinical outcome of 477 intermediate-risk cytogenetic AML patients receiving cytarabine-based chemotherapy. Patients younger than 50 years old with the NT5C2 rs10883841 AA genotype had lower overall survival (OS) (p: 0.003; HR 2.16, 95%CI 1.29 - 3.61) and lower disease-free survival (DFS) (p: 0.002; HR 2.45, 95%CI 1.41 - 4.27), associated to a higher relapse incidence (p: 0.010; HR 2.23, 95%CI 1.21 - 4.12). Interestingly, subgroup analysis showed that the negative effect of the NT5C2 rs10883841 AA genotype was detected in all subgroups except in patients with nucleophosmin mutation without high ratio FLT-3 internal tandem duplication. CDA polymorphisms were associated with the complete remission rate after induction chemotherapy, without influencing OS. Further studies are warranted to determine whether this pharmacogenomic approach may be helpful to individualize AML treatment.
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Affiliation(s)
- Johana Díaz-Santa
- Hematology Department, Institut Català d'Oncologia - Hospital Dr. Josep Trueta; Institut d'Investigació Biomèdica de Girona (IDIBGI); Josep Carreras Research Institute, Girona; Universitat de Girona, Girona, Spain
| | - Rocío Rodríguez-Romanos
- Hematology Department, Institut Català d'Oncologia - Hospital Dr. Josep Trueta; Institut d'Investigació Biomèdica de Girona (IDIBGI); Josep Carreras Research Institute, Girona; Universitat de Girona, Girona, Spain
| | - Rosa Coll
- Hematology Department, Institut Català d'Oncologia - Hospital Dr. Josep Trueta; Institut d'Investigació Biomèdica de Girona (IDIBGI); Josep Carreras Research Institute, Girona; Universitat de Girona, Girona, Spain
| | - Gemma Osca
- Hematology Department, Institut Català d'Oncologia - Hospital Dr. Josep Trueta; Institut d'Investigació Biomèdica de Girona (IDIBGI); Josep Carreras Research Institute, Girona; Universitat de Girona, Girona, Spain
| | - Marta Pratcorona
- Hematology Department, Hospital de la Santa Creu i Sant Pau; Institut d'Investigació Biomèdica Sant Pau; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta González-Bartulos
- Hematology Department, Institut Català d'Oncologia - Hospital Dr. Josep Trueta; Institut d'Investigació Biomèdica de Girona (IDIBGI); Josep Carreras Research Institute, Girona; Universitat de Girona, Girona, Spain
| | - Ana Garrido
- Hematology Department, Hospital de la Santa Creu i Sant Pau; Institut d'Investigació Biomèdica Sant Pau; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Angona
- Hematology Department, Institut Català d'Oncologia - Hospital Dr. Josep Trueta; Institut d'Investigació Biomèdica de Girona (IDIBGI); Josep Carreras Research Institute, Girona; Universitat de Girona, Girona, Spain
| | - Carme Talarn
- Hematology Department, Institut Català d'Oncologia - Hospital Joan XXIII, Tarragona, Spain
| | - Mar Tormo
- Hematology Department, Hospital Clínico Universitario, Valencia, Spain
| | - Montserrat Arnan
- Hematology Department, Institut Català d'Oncologia - Hospital Duran I Reynals; Institut d'Investigació Biomèdica de Bellvitge (IDIBELL); Universitat de Barcelona, L'Hospitalet, Barcelona, Spain
| | - Susanna Vives
- Institut Català d'Oncologia - Hospital Germans Trias i Pujol; Josep Carreras Research Institute, Badalona; Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - Olga Salamero
- Hematology Department, Hospital Universitari Vall d'Hebró. Barcelona, Spain
| | - Esperanza Tuset
- Hematology Department, Institut Català d'Oncologia - Hospital Dr. Josep Trueta; Institut d'Investigació Biomèdica de Girona (IDIBGI); Josep Carreras Research Institute, Girona; Universitat de Girona, Girona, Spain
| | - Natàlia Lloveras
- Hematology Department, Institut Català d'Oncologia - Hospital Dr. Josep Trueta; Institut d'Investigació Biomèdica de Girona (IDIBGI); Josep Carreras Research Institute, Girona; Universitat de Girona, Girona, Spain
| | - Isabel Díez
- Hematology Department, Institut Català d'Oncologia - Hospital Dr. Josep Trueta; Institut d'Investigació Biomèdica de Girona (IDIBGI); Josep Carreras Research Institute, Girona; Universitat de Girona, Girona, Spain
| | - Lurdes Zamora
- Institut Català d'Oncologia - Hospital Germans Trias i Pujol; Josep Carreras Research Institute, Badalona; Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - Joan Bargay
- Hematology Department, Hospital de Son Llàtzer, Palma de Mallorca, Spain
| | - Antonia Sampol
- Hematology Department, Hospital Son Espases. Palma de Mallorca, Spain
| | - David Cruz
- Hematology Department, Institut Català d'Oncologia - Hospital Dr. Josep Trueta; Institut d'Investigació Biomèdica de Girona (IDIBGI); Josep Carreras Research Institute, Girona; Universitat de Girona, Girona, Spain
| | - Jordi Vila
- Hematology Department, Institut Català d'Oncologia - Hospital Dr. Josep Trueta; Institut d'Investigació Biomèdica de Girona (IDIBGI); Josep Carreras Research Institute, Girona; Universitat de Girona, Girona, Spain
| | - Marta Sitges
- Hematology Department, Institut Català d'Oncologia - Hospital Dr. Josep Trueta; Institut d'Investigació Biomèdica de Girona (IDIBGI); Josep Carreras Research Institute, Girona; Universitat de Girona, Girona, Spain
| | - Antoni Garcia
- Hematology Department, Hospital Arnau de Vilanova. Lleida, Spain
| | | | - Jordi Esteve
- Hematology Department, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Jorge Sierra
- Hematology Department, Hospital de la Santa Creu i Sant Pau; Institut d'Investigació Biomèdica Sant Pau; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - David Gallardo
- Hematology Department, Institut Català d'Oncologia - Hospital Dr. Josep Trueta; Institut d'Investigació Biomèdica de Girona (IDIBGI); Josep Carreras Research Institute, Girona; Universitat de Girona, Girona, Spain
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Megías-Vericat JE, Martínez-Cuadrón D, Solana-Altabella A, Montesinos P. Precision medicine in acute myeloid leukemia: where are we now and what does the future hold? Expert Rev Hematol 2020; 13:1057-1065. [PMID: 32869672 DOI: 10.1080/17474086.2020.1818559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Precision medicine has revolutionized the diagnostic and therapeutic management of acute myeloid leukemia (AML), from standardized schemes based on chemotherapy to tailored approaches according to molecular and genetic profile and targeted therapy. AREAS COVERED The main topics of precision medicine in AML were reviewed in MEDLINE, EMBASE, and Cochrane Central Register databases, and future directions in this therapeutic area were addressed. This review included targeted therapies, drug-sensitivity tests and predictive biomarkers, and genetic studies employing pharmacogenetic and deep sequencing strategies. EXPERT OPINION Precision medicine has opened the door to personalized therapy for specific AML patient populations with promising results. Several targeted therapies have been approved or are being tested for specific mutations (i.e. FLT3, IDH, BCL-2, TP53), obtaining improvements in clinical outcomes and less toxicity as compared with intensive treatment, allowing potential combination therapy. Ongoing trials and real data will establish the role of these molecules in monotherapy or combined in different AML settings (front-line, relapsed/refractory, or post-transplant). Experience in drug-sensitivity predictors and pharmacogenetic biomarkers is encouraging and could be useful tools in the next years, but we need a better understanding of AML biology and pathogenesis as well as confirmatory studies to demonstrate the utility in clinical practice.
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Affiliation(s)
| | - David Martínez-Cuadrón
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe , Valencia, Spain.,CIBERONC, Instituto de Salud Carlos III , Madrid, Spain
| | - Antonio Solana-Altabella
- Servicio de Farmacia, Área del Medicamento, Hospital Universitari i Politècnic La Fe , Valencia, Spain
| | - Pau Montesinos
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe , Valencia, Spain.,CIBERONC, Instituto de Salud Carlos III , Madrid, Spain
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de Souza MR, Rohr P, Kahl VFS, Kvitko K, Cappetta M, Lopes WM, Simon D, da Silva J. The influence of polymorphisms of xenobiotic-metabolizing and DNA repair genes in DNA damage, telomere length and global DNA methylation evaluated in open-cast coal mining workers. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 189:109975. [PMID: 31787382 DOI: 10.1016/j.ecoenv.2019.109975] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/11/2019] [Accepted: 11/13/2019] [Indexed: 06/10/2023]
Abstract
Coal plants represent one of the main sources of environmental pollution due to the combustion process of this mineral and the consequent release of gases and particles which, in significant quantities, can lead to a potential risk to health and the environment. The susceptibility of individuals to the genotoxic effects of coal mining can be modulated by genetic variations in the xenobiotic detoxification and DNA repair processes. The aim of this study was to evaluate if xenobiotic metabolism polymorphism, base excision repair polymorphisms and non-homologous end joining repair polymorphism, could modify individual susceptibility to genomic instability and epigenetic alterations induced in workers by occupational exposure to coal. In this study, polymerase chain reaction was used to examine the polymorphic sites. The sample population comprising 70 coal mine workers and 71 workers non-exposed to coal. Our results demonstrated the effect of individual genotypes on different biomarkers evaluated. Significant decrease in % of global DNA methylation were observed in CYP1A1 Val/- exposed individuals compared to CYP1A1 Ile/Ile individuals. Coal workers who carried the XRCC4 Ile/Ile genotype showed decrease NBUD frequencies, while the XRCC4 Thr/- genotype was associated with decrease in Buccal micronucleus cells for the group not exposed. No influence of GSTM1 null, GSTT1 null, GSTP1 Ile105Val, hOGG1 Ser326Cys, XRCC1 Arg194Trp polymorphisms was observed. Thus, the current study reinforces the importance of considering the effect of metabolizing and repair variant genotypes on the individual susceptibility to incorporate DNA damage, as these processes act in a coordinated manner to determine the final response to coal exposure.
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Affiliation(s)
- Melissa Rosa de Souza
- Laboratory of Genetic Toxicology, Post-Graduate Program in Cellular and Molecular Biology Applied to Health, Lutheran University of Brazil (ULBRA), Canoas, RS, Brazil
| | - Paula Rohr
- Laboratory of Genetic Toxicology, Post-Graduate Program in Cellular and Molecular Biology Applied to Health, Lutheran University of Brazil (ULBRA), Canoas, RS, Brazil
| | | | - Kátia Kvitko
- Laboratory of Immunogenetics, Post-Graduate Program in Genetics and Molecular Biology (PPGBM), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Mónica Cappetta
- Laboratory of Genetic Epidemiology, Department of Genetics, Medicine School, Universidad de la República, Montevideo, Uruguay
| | - Wilner Martinez Lopes
- Department of Genetic Toxicology and Chromosome Pathology, Instituto de Investigaciones Biologicas Clemente Estable, Montevideo, Uruguay
| | - Daniel Simon
- Laboratory of Human Molecular Genetics, Post-Graduate Program in Cellular and Molecular Biology Applied to Health, Lutheran University of Brazil (ULBRA), Canoas, RS, Brazil
| | - Juliana da Silva
- Laboratory of Genetic Toxicology, Post-Graduate Program in Cellular and Molecular Biology Applied to Health, Lutheran University of Brazil (ULBRA), Canoas, RS, Brazil; Laboratory of Genetic Toxicology, La Salle University (UniLaSalle), Canoas, RS, Brazil.
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Puty TC, Sarraf JS, Do Carmo Almeida TC, Filho VCB, de Carvalho LEW, Fonseca FLA, Adami F. Evaluation of the impact of single-nucleotide polymorphisms on treatment response, survival and toxicity with cytarabine and anthracyclines in patients with acute myeloid leukaemia: a systematic review protocol. Syst Rev 2019; 8:109. [PMID: 31053175 PMCID: PMC6499963 DOI: 10.1186/s13643-019-1011-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 04/01/2019] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Acute myeloid leukaemia is the most common type of acute leukaemia in the world. Thus, the study of genetic alterations, such as single-nucleotide polymorphisms (SNPs), has contributed to a better understanding of the mechanisms underlying leukaemogenesis, to improve the prognosis and to increase the survival of these patients. However, there is no synthesis of evidence in the literature evaluating the quality of evidence and the risk of bias in the studies such that the results can be translated. Thus, this systematic review protocol aims to assess the impact of SNPs on genes involved in the metabolism of cytarabine and anthracyclines with respect to survival, treatment response and toxicity in patients with AML. METHODS This systematic review protocol is based on PRISMA guidelines and includes searches in six electronic databases, contact with authors, repositories of clinical trials, and cancer research. Studies published in peer-reviewed journals will be included if they meet the eligibility criteria: (a) samples composed of individuals of any age, of both sexes, with a diagnosis of AML, regardless of the time of diagnosis of disease; (b) participants who have undergone or are undergoing cytarabine- and anthracycline-associated chemotherapy or cytarabine-only chemotherapy; and (c) in vivo studies. Studies that include patients with promyelocytic leukaemia (Fab type 3) will be excluded because this disease has different treatment. The process of study selection, data extraction, and evaluation/synthesis will be performed in duplicate. Assessment of methodological quality and risk of bias will be performed using the Cochrane Risk of Bias Tool for randomized clinical studies and the Downs-Black Checklist for cohort and case-control studies. The synthesis of evidence will include the level of evidence based on the GRADE protocol. A meta-analysis of the association between SNPs and outcomes may be performed based on Cochrane guidelines. DISCUSSION It is expected that clinical decisions for AML patients will consider evidence-based practices to contribute to better patient management. In this way, we will be able to define how to treat patients with AML to improve their survival and quality of life. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018100750.
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Affiliation(s)
- Taynah Cascaes Puty
- Ensino e Pesquisa, Oncológica do Brasil Ensino e Pesquisa, Belém, Brazil
- Laboratório de Epidemiologia e Análise de Dados, Faculdade de Medicina do ABC, Santo André, Brazil
| | - Jonathan Souza Sarraf
- Ensino e Pesquisa, Oncológica do Brasil Ensino e Pesquisa, Belém, Brazil
- Laboratório de Epidemiologia e Análise de Dados, Faculdade de Medicina do ABC, Santo André, Brazil
- Universidade Federal do Pará, Belém, Brazil
- Faculdade de Ciências Naturais, ICEN, UFPA, Belém, Brazil
| | | | | | - Luis Eduardo Werneck de Carvalho
- Ensino e Pesquisa, Oncológica do Brasil Ensino e Pesquisa, Belém, Brazil
- Laboratório de Epidemiologia e Análise de Dados, Faculdade de Medicina do ABC, Santo André, Brazil
| | | | - Fernando Adami
- Laboratório de Epidemiologia e Análise de Dados, Faculdade de Medicina do ABC, Santo André, Brazil
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Sissung TM, Rajan A, Blumenthal GM, Liewehr DJ, Steinberg SM, Berman A, Giaccone G, Figg WD. Reproducibility of pharmacogenetics findings for paclitaxel in a heterogeneous population of patients with lung cancer. PLoS One 2019; 14:e0212097. [PMID: 30817750 PMCID: PMC6394902 DOI: 10.1371/journal.pone.0212097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 01/28/2019] [Indexed: 12/12/2022] Open
Abstract
Pharmacogenetics studies have identified several allelic variants with the potential to reduce toxicity and improve treatment outcome. The present study was designed to determine if such findings are reproducible in a heterogenous population of patients with lung cancer undergoing therapy with paclitaxel. We designed a prospective multi-institutional study that recruited n = 103 patients receiving paclitaxel therapy with a 5-year follow up. All patients were genotyped using the Drug Metabolizing Enzymes and Transporters (DMET) platform, which ascertains 1931 genotypes in 235 genes. Progression-free survival (PFS) of paclitaxel therapy and clinically-significant paclitaxel toxicities were classified and compared according to genotype. Initial screening revealed eleven variants that are associated with PFS. Of these, seven variants in ABCB11 (rs4148768), ABCC3 (rs1051640), ABCG1 (rs1541290), CYP8B1 (rs735320), NR3C1 (rs6169), FMO6P (rs7889839), and GSTM3 (rs7483) were associated with paclitaxel PFS in a multivariate analysis accounting for clinical covariates. Multivariate analysis revealed four SNPs in VKORC1 (rs2884737), SLC22A14 (rs4679028), GSTA2 (rs6577), and DCK (rs4643786) were associated with paclitaxel toxicities. With the exception of a variant in VKORC1, the present study did not find the same genetic outcome associations of other published research on pharmacogenetics variants that affect paclitaxel outcomes. This finding suggests that prior pharmacogenomics research findings may not be reproduced in the most frequently-diagnosed malignancy, lung cancer.
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Affiliation(s)
- Tristan M. Sissung
- Clinical Pharmacology Program, Office of the Clinical Director, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Arun Rajan
- Thoracic and Gastrointestinal Oncology Branch, Office of the Clinical Director, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Gideon M. Blumenthal
- Thoracic and Gastrointestinal Oncology Branch, Office of the Clinical Director, National Cancer Institute, Bethesda, Maryland, United States of America
| | - David J. Liewehr
- Biostatistics and Data Management Section, Office of the Clinical Director, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Seth M. Steinberg
- Biostatistics and Data Management Section, Office of the Clinical Director, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Arlene Berman
- Office of Research Nursing in the Office of the Clinical Director, Office of the Clinical Director, National Cancer Institute, Bethesda, MD, United States of America
| | - Giuseppe Giaccone
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C., United States of America
| | - William D. Figg
- Clinical Pharmacology Program, Office of the Clinical Director, National Cancer Institute, Bethesda, Maryland, United States of America
- * E-mail:
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Cohen R, Preta LH, Joste V, Curis E, Huillard O, Jouinot A, Narjoz C, Thomas-Schoemann A, Bellesoeur A, Tiako Meyo M, Quilichini J, Desaulle D, Nicolis I, Cessot A, Vidal M, Goldwasser F, Alexandre J, Blanchet B. Determinants of the interindividual variability in serum cytidine deaminase activity of patients with solid tumours. Br J Clin Pharmacol 2019; 85:1227-1238. [PMID: 30701582 DOI: 10.1111/bcp.13849] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 10/23/2018] [Accepted: 12/14/2018] [Indexed: 01/30/2023] Open
Abstract
AIMS Cytidine deaminase (CDA) activity in cancer patients' serum has been proposed as a predictive biomarker for efficacy and toxicity of nucleoside analogues. However, discrepant results about its predictive value have been reported due to the high interindividual variability in CDA activity. This study aimed at identifying determinants of this interindividual variability. METHODS From December 2014 to November 2015, 183 patients were prospectively included. Serum CDA activity, biological and clinical characteristics as well as five common single nucleotide polymorphisms (SNPs) in the CDA gene (c.-451C > T, c.-92A > G, c.-33_-31delC, c.79A > C, c.435 T > C) were analysed. Associations between clinical characteristics, pharmacogenetic variants and CDA activity were univariately tested. P < 0.1-candidate variables were analysed through a multivariate analysis. The association between CDA activity and toxicity was assessed for the 56 gemcitabine-treated patients. Intraindividual variability in CDA activity was explored in six pancreatic cancer patients treated with gemcitabine. RESULTS Median CDA activity was 3.97 U mg-1 (range 1.53-15.49 U mg-1 ). A univariate analysis showed that CDA activity was statistically associated with Eastern Cooperative Oncology Group performance status, mild or severe malnutrition, inflammatory syndrome, leucocyte count, neutrophil count, albumin, C-reactive protein and -c.-33_-31delC single nucleotide polymorphism. A multivariate analysis identified that only neutrophil count (P < 0.0001) and severe malnutrition (P = 0.0278) were independently associated with CDA activity. Low CDA activity (<2 U mg-1 ) was not statistically associated with severe gemcitabine-related toxicities (P = 0.16). A decrease in CDA activity was observed during the longitudinal follow-up of six pancreatic cancer patients treated with gemcitabine (P = 0.03). CONCLUSIONS These results suggest that neutrophil count and malnutrition should be considered for the interpretation of pretherapeutic CDA activity.
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Affiliation(s)
- R Cohen
- Department of Medical Oncology, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - L H Preta
- Pharmacokinetics and Pharmacochemistry Unit, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - V Joste
- Biochemistry Unit, Georges Pompidou European Hospital, Paris Descartes University, AP-HP, Paris, France
| | - E Curis
- Laboratory of biomathematics, plateau iB2, Pharmacy Faculty, University of Paris Descartes, Paris, France
| | - O Huillard
- Department of Medical Oncology, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - A Jouinot
- Department of Medical Oncology, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - C Narjoz
- Biochemistry Unit, Georges Pompidou European Hospital, Paris Descartes University, AP-HP, Paris, France
| | - A Thomas-Schoemann
- UMR8638 CNRS, Paris Descartes University, Pharmacy Faculty, University of Paris Descartes, Paris, France.,Multidisciplinary risk assessment and Drug Monitoring, Cochin Hospital, AP-HP, Paris
| | - A Bellesoeur
- Multidisciplinary risk assessment and Drug Monitoring, Cochin Hospital, AP-HP, Paris
| | - M Tiako Meyo
- Pharmacokinetics and Pharmacochemistry Unit, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - J Quilichini
- Pharmacokinetics and Pharmacochemistry Unit, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - D Desaulle
- Laboratory of biomathematics, EA 4064 Environmental epidemiology and impact of pollution on health, Pharmacy Faculty, University of Paris Descartes, Paris, France
| | - I Nicolis
- Laboratory of biomathematics, EA 4064 Environmental epidemiology and impact of pollution on health, Pharmacy Faculty, University of Paris Descartes, Paris, France
| | - A Cessot
- Department of Medical Oncology, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - M Vidal
- Pharmacokinetics and Pharmacochemistry Unit, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France.,UMR8638 CNRS, Paris Descartes University, Pharmacy Faculty, University of Paris Descartes, Paris, France
| | - F Goldwasser
- Department of Medical Oncology, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - J Alexandre
- Department of Medical Oncology, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
| | - B Blanchet
- Pharmacokinetics and Pharmacochemistry Unit, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France.,UMR8638 CNRS, Paris Descartes University, Pharmacy Faculty, University of Paris Descartes, Paris, France
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7
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Elsayed AH, Cao X, Crews KR, Gandhi V, Plunkett W, Rubnitz JE, Ribeiro RC, Pounds SB, Lamba JK. Comprehensive Ara-C SNP score predicts leukemic cell intracellular ara-CTP levels in pediatric acute myeloid leukemia patients. Pharmacogenomics 2018; 19:1101-1110. [PMID: 30088438 DOI: 10.2217/pgs-2018-0086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
AIM Cytarabine (Ara-C), a mainstay of acute myeloid leukemia (AML) treatment, is a prodrug requiring activation to ara-CTP for its antileukemic activity. Aim of this study was to evaluate impact of genetic variants in the key genes involved in ara-C metabolism on the leukemic cell intracellular levels of ara-CTP. METHOD We investigated SNPs in 14 ara-C metabolic-pathway genes, for association with intracellular ara-CTP levels, in leukemic cells obtained post-initiation of cytarabine infusion in pediatric AML patients (n = 68). RESULTS Nine SNPs were significantly associated with leukemic cell intracellular concentration of ara-CTP. A comprehensive ara-CTP-SNP-score (ACSS) was further developed from top four SNPs identified in regression model. Patients were classified into three groups based on ACSS: high-ACSS (score >0), intermediate-ACSS (score = 0) and low-ACSS (score <0). ACSS designation was significant predictor of intracellular ara-CTP levels (p = 0.00012), suggesting a cumulative or synergistic effect of the significant SNPs. CONCLUSION ACSS score designation holds promise in definfing ara-C dose. Validation of the clinical utility of ACSS score in other independent cohorts will help identification of patients with potentially lower or higher levels of the ara-CTP in leukemic cells, thereby opening up opportunities for dose management to reduce toxicity and enhance efficacy.
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Affiliation(s)
- Abdelrahman H Elsayed
- Department of Pharmacotherapy & Translational Research, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Xueyuan Cao
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN 38105, USA.,Department of Acute & Tertiary Care, University of Tennessee Health Science Center, Memphis 38163, TN, USA
| | - Kristine R Crews
- Department of Pharmaceutical Sciences, St Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Varsha Gandhi
- Department of Experimental Therapeutics, MD Anderson Cancer Center, Houston, TX 77054, USA
| | - William Plunkett
- Department of Experimental Therapeutics, MD Anderson Cancer Center, Houston, TX 77054, USA
| | - Jeffrey E Rubnitz
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Raul C Ribeiro
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Stanley B Pounds
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Jatinder K Lamba
- Department of Pharmacotherapy & Translational Research, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
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Tsesmetzis N, Paulin CBJ, Rudd SG, Herold N. Nucleobase and Nucleoside Analogues: Resistance and Re-Sensitisation at the Level of Pharmacokinetics, Pharmacodynamics and Metabolism. Cancers (Basel) 2018; 10:cancers10070240. [PMID: 30041457 PMCID: PMC6071274 DOI: 10.3390/cancers10070240] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 07/18/2018] [Accepted: 07/20/2018] [Indexed: 02/07/2023] Open
Abstract
Antimetabolites, in particular nucleobase and nucleoside analogues, are cytotoxic drugs that, starting from the small field of paediatric oncology, in combination with other chemotherapeutics, have revolutionised clinical oncology and transformed cancer into a curable disease. However, even though combination chemotherapy, together with radiation, surgery and immunotherapy, can nowadays cure almost all types of cancer, we still fail to achieve this for a substantial proportion of patients. The understanding of differences in metabolism, pharmacokinetics, pharmacodynamics, and tumour biology between patients that can be cured and patients that cannot, builds the scientific basis for rational therapy improvements. Here, we summarise current knowledge of how tumour-specific and patient-specific factors can dictate resistance to nucleobase/nucleoside analogues, and which strategies of re-sensitisation exist. We revisit well-established hurdles to treatment efficacy, like the blood-brain barrier and reduced deoxycytidine kinase activity, but will also discuss the role of novel resistance factors, such as SAMHD1. A comprehensive appreciation of the complex mechanisms that underpin the failure of chemotherapy will hopefully inform future strategies of personalised medicine.
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Affiliation(s)
- Nikolaos Tsesmetzis
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden.
| | - Cynthia B J Paulin
- Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institutet, 171 65 Stockholm, Sweden.
| | - Sean G Rudd
- Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institutet, 171 65 Stockholm, Sweden.
| | - Nikolas Herold
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden.
- Paediatric Oncology, Theme of Children's and Women's Health, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden.
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9
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Pesi R, Petrotto E, Colombaioni L, Allegrini S, Garcia-Gil M, Camici M, Jordheim LP, Tozzi MG. Cytosolic 5'-Nucleotidase II Silencing in a Human Lung Carcinoma Cell Line Opposes Cancer Phenotype with a Concomitant Increase in p53 Phosphorylation. Int J Mol Sci 2018; 19:E2115. [PMID: 30037008 PMCID: PMC6073589 DOI: 10.3390/ijms19072115] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 12/28/2022] Open
Abstract
Purine homeostasis is maintained by a purine cycle in which the regulated member is a cytosolic 5'-nucleotidase II (cN-II) hydrolyzing IMP and GMP. Its expression is particularly high in proliferating cells, indeed high cN-II activity or expression in hematological malignancy has been associated to poor prognosis and chemoresistance. Therefore, a strong interest has grown in developing cN-II inhibitors, as potential drugs alone or in combination with other compounds. As a model to study the effect of cN-II inhibition we utilized a lung carcinoma cell line (A549) in which the enzyme was partially silenced and its low activity conformation was stabilized through incubation with 2-deoxyglucose. We measured nucleotide content, reduced glutathione, activities of enzymes involved in glycolysis and Krebs cycle, protein synthesis, mitochondrial function, cellular proliferation, migration and viability. Our results demonstrate that high cN-II expression is associated with a glycolytic, highly proliferating phenotype, while silencing causes a reduction of proliferation, protein synthesis and migration ability, and an increase of oxidative performances. Similar results were obtained in a human astrocytoma cell line. Moreover, we demonstrate that cN-II silencing is concomitant with p53 phosphorylation, suggesting a possible involvement of this pathway in mediating some of cN-II roles in cancer cell biology.
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Affiliation(s)
- Rossana Pesi
- Unità di Biochimica, Dipartimento di Biologia, Università di Pisa, Via San Zeno 51, 56127 Pisa, Italy.
| | - Edoardo Petrotto
- Unità di Biochimica, Dipartimento di Biologia, Università di Pisa, Via San Zeno 51, 56127 Pisa, Italy.
| | - Laura Colombaioni
- Istituto di Neuroscienze, CNR, Via Giuseppe Moruzzi 1, 56124 Pisa, Italy.
| | - Simone Allegrini
- Unità di Biochimica, Dipartimento di Biologia, Università di Pisa, Via San Zeno 51, 56127 Pisa, Italy.
| | - Mercedes Garcia-Gil
- Unità Fisiologia Generale, Dipartimento di Biologia, Università di Pisa, Via San Zeno 31, 56127 Pisa, Italy.
| | - Marcella Camici
- Unità di Biochimica, Dipartimento di Biologia, Università di Pisa, Via San Zeno 51, 56127 Pisa, Italy.
| | - Lars Petter Jordheim
- Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de Recherche en Cancérologie de Lyon, Lyon 69008, France.
| | - Maria Grazia Tozzi
- Unità di Biochimica, Dipartimento di Biologia, Università di Pisa, Via San Zeno 51, 56127 Pisa, Italy.
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10
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Di Tullio A, Rouault-Pierre K, Abarrategi A, Mian S, Grey W, Gribben J, Stewart A, Blackwood E, Bonnet D. The combination of CHK1 inhibitor with G-CSF overrides cytarabine resistance in human acute myeloid leukemia. Nat Commun 2017; 8:1679. [PMID: 29162833 PMCID: PMC5698422 DOI: 10.1038/s41467-017-01834-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 10/19/2017] [Indexed: 12/30/2022] Open
Abstract
Cytarabine (AraC) represents the most effective single agent treatment for AML. Nevertheless, overriding AraC resistance in AML remains an unmet medical need. Here we show that the CHK1 inhibitor (CHK1i) GDC-0575 enhances AraC-mediated killing of AML cells both in vitro and in vivo, thus abrogating any potential chemoresistance mechanisms involving DNA repair. Importantly, this combination of drugs does not affect normal long-term hematopoietic stem/progenitors. Moreover, the addition of CHK1i to AraC does not generate de novo mutations and in patients' samples where AraC is mutagenic, addition of CHK1i appears to eliminate the generation of mutant clones. Finally, we observe that persistent residual leukemic cells are quiescent and can become responsive to the treatment when forced into cycle via granulocyte colony-stimulating factor (G-CSF) administration. This drug combination (AraC+CHK1i+G-CSF) will open the doors for a more efficient treatment of AML in the clinic.
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MESH Headings
- Animals
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Cell Line, Tumor
- Checkpoint Kinase 1/antagonists & inhibitors
- Cytarabine/administration & dosage
- Drug Resistance, Neoplasm
- Female
- Granulocyte Colony-Stimulating Factor/administration & dosage
- HL-60 Cells
- Hematopoiesis/drug effects
- Humans
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Male
- Mice
- Mice, Inbred NOD
- Mice, SCID
- Mutation/drug effects
- Piperidines/administration & dosage
- Protein Kinase Inhibitors/administration & dosage
- Pyridines/administration & dosage
- Pyrroles/administration & dosage
- U937 Cells
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Alessandro Di Tullio
- Hematopoietic Stem Cell Laboratory, The Francis Crick Institute, 1 Midland Road, NW1 1AT, London, UK
| | - Kevin Rouault-Pierre
- Hematopoietic Stem Cell Laboratory, The Francis Crick Institute, 1 Midland Road, NW1 1AT, London, UK
- Department of Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, Chaterhouse Square, EC1M 6BQ, London, UK
| | - Ander Abarrategi
- Hematopoietic Stem Cell Laboratory, The Francis Crick Institute, 1 Midland Road, NW1 1AT, London, UK
| | - Syed Mian
- Hematopoietic Stem Cell Laboratory, The Francis Crick Institute, 1 Midland Road, NW1 1AT, London, UK
- King's College London School of Medicine, Department of Haematological Medicine, The Rayne Institute, 123 Coldharbour Lane, SE5 9NU, London, UK
| | - William Grey
- Hematopoietic Stem Cell Laboratory, The Francis Crick Institute, 1 Midland Road, NW1 1AT, London, UK
| | - John Gribben
- Department of Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, Chaterhouse Square, EC1M 6BQ, London, UK
| | - Aengus Stewart
- Bioinformatic Core, The Francis Crick Institute, 1 Midland Road, NW1 1AT, London, UK
| | | | - Dominique Bonnet
- Hematopoietic Stem Cell Laboratory, The Francis Crick Institute, 1 Midland Road, NW1 1AT, London, UK.
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11
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Cao HX, Miao CF, Yan L, Tang P, Zhang LR, Sun L. Polymorphisms at microRNA binding sites of Ara-C and anthracyclines-metabolic pathway genes are associated with outcome of acute myeloid leukemia patients. J Transl Med 2017; 15:235. [PMID: 29141648 PMCID: PMC5688732 DOI: 10.1186/s12967-017-1339-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 11/04/2017] [Indexed: 12/11/2022] Open
Abstract
Background Gene polymorphisms at microRNA-binding sites (poly-miRTS) may affect gene transcription and expression through miRNA regulation, which is associated with cancer susceptibility, sensitivity to chemotherapy and prognosis. This study investigated the association between poly-miRTS of Ara-C/anthracycline metabolic pathways genes and the outcome of acute myeloid leukemia (AML) in Chinese patients after Ara-C-based chemotherapy. Methods A total of 17 poly-miRTS were selected from the SNPinfo Web Server and genotyped in 206 Chinese Han non-FAB-M3 AML patients using the SEQUENOM Mass-ARRAY system. Results Among these 17 poly-miRTS, five Ara-C metabolic gene single nucleotide polymorphisms (SNPs, NT5C2 rs10786736 and rs8139, SLC29A1 rs3734703, DCTD rs7278, and RRM1 rs1042919) were identified to significantly associate with complete AML remission and/or overall and relapse-free survival (OS and RFS, respectively), and four anthracycline-metabolic gene SNPs (ABCC1 rs3743527, rs212091, and rs212090 and CBR1 rs9024) were significantly associated with chemotherapy-related toxicities. Moreover, SLC29A1 rs3734703 was shown to associate with both chemotherapy response and survival (adjusted OR 2.561 in the overdominant model; adjusted HR 2.876 for OS and 2.357 for RFS in the dominant model). Conclusions The data from the current study demonstrated that the poly-miRTS of Ara-C/anthracyclines metabolic genes predicted the sensitivity and side effects of AML to Ara-C-based chemotherapy and patient survival. Further study will confirm them as biomarkers for AML patients after Ara-C-based chemotherapy. Electronic supplementary material The online version of this article (10.1186/s12967-017-1339-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hai-Xia Cao
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshedong Road, Zhengzhou, 450052, Henan, China
| | - Chao-Feng Miao
- Department of Vascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Liang Yan
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Ping Tang
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Li-Rong Zhang
- Department of Pharmacology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450052, China
| | - Ling Sun
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshedong Road, Zhengzhou, 450052, Henan, China.
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12
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Megías-Vericat JE, Montesinos P, Herrero MJ, Moscardó F, Bosó V, Martínez-Cuadrón D, Rojas L, Rodríguez-Veiga R, Boluda B, Sendra L, Cervera J, Poveda JL, Sanz MÁ, Aliño SF. Influence of cytarabine metabolic pathway polymorphisms in acute myeloid leukemia induction treatment. Leuk Lymphoma 2017; 58:2880-2894. [PMID: 28573946 DOI: 10.1080/10428194.2017.1323267] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Cytarabine is considered the most effective chemotherapeutic option in acute myeloid leukemia (AML). The impact of 10 polymorphisms in cytarabine metabolic pathway genes were evaluated in 225 adult de novo AML patients. Variant alleles of DCK rs2306744 and CDA rs602950 showed higher complete remission (p = .024, p = .045), with lower survival rates for variant alleles of CDA rs2072671 (p = .015, p = .045, p = .032), rs3215400 (p = .033) and wild-type genotype of rs602950 (p = .039, .014). Induction death (p = .033) and lower survival rates (p = .021, p = .047) were correlated to RRM1 rs9937 variant allele. In addition, variant alleles of CDA rs532545 and rs602950 were related to skin toxicity (p = .031, p = .049) and mucositis to DCK rs2306744 minor allele (p = .046). Other toxicities associated to variant alleles were hepatotoxicity to NT5C2 rs11598702 (p = .032), lung toxicity (p = .031) and thrombocytopenia to DCK rs4694362 (p = .046). This study supports the interest of cytarabine pathway polymorphisms regarding efficacy and toxicity of AML therapy in a coherent integrated manner.
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Affiliation(s)
- Juan Eduardo Megías-Vericat
- a Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento , Hospital Universitario y Politécnico La Fe. , Valencia , Spain.,b Servicio de Farmacia, Área del Medicamento , Hospital Universitario y Politécnico La Fe Avda , Valencia , Spain
| | - Pau Montesinos
- c Servicio de Hematología y Hemoterapia , Hospital Universitario y Politécnico La Fe, Avda , Valencia , Spain
| | - María José Herrero
- a Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento , Hospital Universitario y Politécnico La Fe. , Valencia , Spain.,d Departamento Farmacología, Facultad de Medicina , Universidad de Valencia. Avda. , Valencia , Spain
| | - Federico Moscardó
- c Servicio de Hematología y Hemoterapia , Hospital Universitario y Politécnico La Fe, Avda , Valencia , Spain
| | - Virginia Bosó
- a Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento , Hospital Universitario y Politécnico La Fe. , Valencia , Spain.,b Servicio de Farmacia, Área del Medicamento , Hospital Universitario y Politécnico La Fe Avda , Valencia , Spain
| | - David Martínez-Cuadrón
- c Servicio de Hematología y Hemoterapia , Hospital Universitario y Politécnico La Fe, Avda , Valencia , Spain
| | - Luis Rojas
- a Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento , Hospital Universitario y Politécnico La Fe. , Valencia , Spain.,e Department of Internal Medicine, Faculty of Medicine , Pontificia Universidad Católica de Chile , Santiago , Chile
| | - Rebeca Rodríguez-Veiga
- c Servicio de Hematología y Hemoterapia , Hospital Universitario y Politécnico La Fe, Avda , Valencia , Spain
| | - Blanca Boluda
- c Servicio de Hematología y Hemoterapia , Hospital Universitario y Politécnico La Fe, Avda , Valencia , Spain
| | - Luis Sendra
- a Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento , Hospital Universitario y Politécnico La Fe. , Valencia , Spain.,d Departamento Farmacología, Facultad de Medicina , Universidad de Valencia. Avda. , Valencia , Spain
| | - José Cervera
- c Servicio de Hematología y Hemoterapia , Hospital Universitario y Politécnico La Fe, Avda , Valencia , Spain
| | - José Luis Poveda
- b Servicio de Farmacia, Área del Medicamento , Hospital Universitario y Politécnico La Fe Avda , Valencia , Spain
| | - Miguel Ángel Sanz
- c Servicio de Hematología y Hemoterapia , Hospital Universitario y Politécnico La Fe, Avda , Valencia , Spain
| | - Salvador F Aliño
- a Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento , Hospital Universitario y Politécnico La Fe. , Valencia , Spain.,d Departamento Farmacología, Facultad de Medicina , Universidad de Valencia. Avda. , Valencia , Spain.,f Unidad de Farmacología Clínica, Área del Medicamento , Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain
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13
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Cusato J, Boglione L, De Nicolò A, Cardellino CS, Carcieri C, Cariti G, Di Perri G, D'Avolio A. Pharmacogenetic analysis of hepatitis C virus related mixed cryoglobulinemia. Pharmacogenomics 2017; 18:607-611. [PMID: 28453396 DOI: 10.2217/pgs-2016-0040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Mixed cryoglobulinemia (MC) is an extra hepatic hepatitis C virus related problem and different studies suggested genetics' role in predicting this complication. We evaluated the influence of SNPs in IL-28B, SLC29A1, SLC28A2, NT5C2, HNF4 and ABCB1 genes in MC prediction. PATIENTS & METHODS SNPs were evaluated through real-time PCR. RESULTS ABCB1 (gene encoding P-glycoprotein) 3435C>T SNP was associated with MC presence (p = 0.034): related to T allele carriers (CC vs CT/TT), we reached a p-value of 0.013. In the logistic regression analysis baseline viral load >600.000 IU/ml (p < 001), IL28B rs8099917/rs12979860 TT/CC (p < 0.001), NT5 (gene encoding for 5' nucleotidase) 153 TC (p = 0.012) and ABCB1 3435 CT/TT (p = 0.034) genotypes predicted MC presence. CONCLUSION These data could help clinicians to identify patients with higher probability to show MC extra hepatic complication.
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Affiliation(s)
- Jessica Cusato
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - Lucio Boglione
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - Amedeo De Nicolò
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - Chiara Simona Cardellino
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - Chiara Carcieri
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - Giuseppe Cariti
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - Giovanni Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - Antonio D'Avolio
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
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14
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Zhang DY, Yuan XQ, Yan H, Cao S, Zhang W, Li XL, Zeng H, Chen XP. Association between DCK 35708 T>C variation and clinical outcomes of acute myeloid leukemia in South Chinese patients. Pharmacogenomics 2016; 17:1519-31. [PMID: 27548009 DOI: 10.2217/pgs-2016-0084] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
AIM DCK is a rate-limiting enzyme in cytarabine activation. rs4643786 and rs67437265 (P122S) variants are reported to affect DCK activity. PATIENTS & METHODS A total of 282 newly diagnosed acute myeloid leukemia (AML) patients were treated with cytarabine combined chemotherapy and genotyped for rs4643786 and rs67437265. Prognosis data were obtained through regular follow-up. DCK mRNA expression was detected in pretreatment blood or bone marrow mononuclear cells. RESULTS rs4643786 showed strong linkage disequilibrium with rs67437265. rs4643786 CT heterozygotes showed significantly higher complete remission rate (p = 0.028), superior overall survival (p = 0.006) and relapse-free survival (p = 0.020) than wild-type TT homozygotes. rs4643786 polymorphism was an independent predictor for AML prognosis. CONCLUSION DCK rs4643786 may serve as an independent predictor of drug response and AML outcome.
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Affiliation(s)
- Dao-Yu Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, PR China.,Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, Hunan, PR China
| | - Xiao-Qing Yuan
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, PR China.,Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, Hunan, PR China
| | - Han Yan
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, PR China.,Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, Hunan, PR China
| | - Shan Cao
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, PR China.,Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, Hunan, PR China
| | - Wei Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, PR China.,Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, Hunan, PR China
| | - Xiao-Lin Li
- Department of Hematology, Xiang-Ya Hospital, Central South University, Changsha 410008, Hunan, PR China
| | - Hui Zeng
- Department of Hematology, Xiang-Ya Hospital, Central South University, Changsha 410008, Hunan, PR China
| | - Xiao-Ping Chen
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, PR China.,Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, Hunan, PR China.,Hunan Province Cooperation Innovation Center for Molecular Target New Drug Study, Hengyang 421001, Hunan, PR China
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15
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Kim JH, Lee C, Cheong HS, Koh Y, Ahn KS, Kim HL, Shin HD, Yoon SS. SLC29A1 (ENT1) polymorphisms and outcome of complete remission in acute myeloid leukemia. Cancer Chemother Pharmacol 2016; 78:533-40. [DOI: 10.1007/s00280-016-3103-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 07/06/2016] [Indexed: 02/08/2023]
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16
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Megías-Vericat JE, Montesinos P, Herrero MJ, Bosó V, Martínez-Cuadrón D, Poveda JL, Sanz MÁ, Aliño SF. Pharmacogenomics and the treatment of acute myeloid leukemia. Pharmacogenomics 2016; 17:1245-1272. [DOI: 10.2217/pgs-2016-0055] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Acute myeloid leukemia (AML) is a clinically and biologically heterogeneous malignancy that is primarily treated with combinations of cytarabine and anthracyclines. Although this scheme remains effective in most of the patients, variability of outcomes in patients has been partly related with their genetic variability. Several pharmacogenetic studies have analyzed the impact of polymorphisms in genes encoding transporters, metabolizers or molecular targets of chemotherapy agents. A systematic review on all eligible studies was carried out in order to estimate the effect of polymorphisms of anthracyclines and cytarabine pathways on efficacy and toxicity of AML treatment. Other emerging genes recently studied in AML, such as DNA repair genes, genes potentially related to chemotherapy response or AML prognosis, have also been included.
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Affiliation(s)
- Juan Eduardo Megías-Vericat
- Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe Avda, Fernando Abril Martorell 106, 46026 – Valencia, Spain
- Servicio de Farmacia, Área del Medicamento, Hospital Universitario y Politécnico La Fe Avda, Fernando Abril Martorell 106, 46026 – Valencia, Spain
| | - Pau Montesinos
- Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe Avda, Fernando Abril Martorell 106, 46026 – Valencia, Spain
| | - María José Herrero
- Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe Avda, Fernando Abril Martorell 106, 46026 – Valencia, Spain
- Departamento Farmacología, Facultad de Medicina, Universidad de Valencia, Avda, Blasco Ibáñez 15, 46010 – Valencia, Spain
| | - Virginia Bosó
- Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe Avda, Fernando Abril Martorell 106, 46026 – Valencia, Spain
- Servicio de Farmacia, Área del Medicamento, Hospital Universitario y Politécnico La Fe Avda, Fernando Abril Martorell 106, 46026 – Valencia, Spain
| | - David Martínez-Cuadrón
- Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe Avda, Fernando Abril Martorell 106, 46026 – Valencia, Spain
| | - José Luis Poveda
- Servicio de Farmacia, Área del Medicamento, Hospital Universitario y Politécnico La Fe Avda, Fernando Abril Martorell 106, 46026 – Valencia, Spain
| | - Miguel Ángel Sanz
- Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe Avda, Fernando Abril Martorell 106, 46026 – Valencia, Spain
| | - Salvador F Aliño
- Unidad de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe Avda, Fernando Abril Martorell 106, 46026 – Valencia, Spain
- Departamento Farmacología, Facultad de Medicina, Universidad de Valencia, Avda, Blasco Ibáñez 15, 46010 – Valencia, Spain
- Unidad de Farmacología Clínica, Área del Medicamento, Hospital Universitario y Politécnico La Fe. Avda. Fernando Abril Martorell 106, 46026 – Valencia, Spain
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17
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Ciccolini J, Serdjebi C, Le Thi Thu H, Lacarelle B, Milano G, Fanciullino R. Nucleoside analogs: ready to enter the era of precision medicine? Expert Opin Drug Metab Toxicol 2016; 12:865-77. [DOI: 10.1080/17425255.2016.1192128] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Joseph Ciccolini
- SMARTc Unit, Inserm S_911 CRO2 Aix-Marseille University, Marseille, France
| | - Cindy Serdjebi
- Assistance Publique Hôpitaux de Marseille. Multidisciplinary Oncology & Therapeutic Innovations dpt, Aix Marseille University, Marseille, France
| | - Hau Le Thi Thu
- SMARTc Unit, Inserm S_911 CRO2 Aix-Marseille University, Marseille, France
| | - Bruno Lacarelle
- SMARTc Unit, Inserm S_911 CRO2 Aix-Marseille University, Marseille, France
| | - Gerard Milano
- Oncopharmacology Unit, Centre Antoine Lacassagne, Nice, France
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18
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Hyo Kim L, Sub Cheong H, Koh Y, Ahn KS, Lee C, Kim HL, Doo Shin H, Yoon SS. Cytidine deaminase polymorphisms and worse treatment response in normal karyotype AML. J Hum Genet 2015; 60:749-54. [PMID: 26354033 DOI: 10.1038/jhg.2015.105] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 07/20/2015] [Accepted: 07/30/2015] [Indexed: 11/09/2022]
Abstract
The cytidine deaminase (CDA) catalyzes the irreversible hydrolytic deamination of the cytarabine (AraC) into a 1-β-D-arabinofuranosyluracil (AraU), an inactive metabolite that plays a crucial role in lowering the amount of AraC, a key chemotherapeutic drug, in the treatment of patients with acute myeloid leukemia (AML). In this study, we hypothesized that CDA polymorphisms were associated with the AraC metabolism for AML treatment and/or related clinical phenotypes. We analyzed 16 polymorphisms of CDA among 50 normal karyotype AML (NK-AML) patients, 45 abnormal karyotype AML (AK-AML) patients and 241 normal controls (NC). Several polymorphisms and haplotypes, rs532545, rs2072671, rs471760, rs4655226, rs818194 and CDA-ht3, were found to have a strong correlation with NK-AML compared with NC and these polymorphisms also revealed strong linkage disequilibrium with each other. Among them, rs2072671 (79A>C), which is located in a coding region and the resultant amino acid change K27Q, showed significant associations with NK-AML compared with NC (P=0.009 and odds ratio=2.44 in the dominant model). The AC and CC genotypes of rs2072671 (79A>C) were significantly correlated with shorter overall survival rates (P=0.03, hazard ratio=1.84) and first complete remission duration (P=0.007, hazard ratio=3.24) compared with the AA genotype in the NK-AML patients. Our results indicate that rs2072671 in CDA may be an important prognostic marker in NK-AML patients.
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Affiliation(s)
- Lyoung Hyo Kim
- Department of Life Science, Sogang University, Seoul, Republic of Korea.,Department of Genetic Epidemiology, SNP Genetics, Seoul, Republic of Korea
| | - Hyun Sub Cheong
- Department of Genetic Epidemiology, SNP Genetics, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Youngil Koh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kwang-Sung Ahn
- Functional Genome Institute, PDXen Biosystem, Seoul, Republic of Korea
| | - Chansu Lee
- Cancer Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyung-Lae Kim
- Department of Biochemistry, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hyoung Doo Shin
- Department of Life Science, Sogang University, Seoul, Republic of Korea.,Department of Genetic Epidemiology, SNP Genetics, Seoul, Republic of Korea
| | - Sung-Soo Yoon
- Cancer Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
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19
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Role of drug transport and metabolism in the chemoresistance of acute myeloid leukemia. Blood Rev 2015; 30:55-64. [PMID: 26321049 DOI: 10.1016/j.blre.2015.08.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 08/04/2015] [Accepted: 08/10/2015] [Indexed: 01/18/2023]
Abstract
Acute myeloid leukemia is a clonal but heterogeneous disease differing in molecular pathogenesis, clinical features and response to chemotherapy. This latter frequently consists of a combination of cytarabine and anthracyclines, although etoposide, demethylating agents, and other drugs are also used. Unfortunately, chemoresistance is a common and serious problem. Multiple mechanisms account for impaired effectiveness of drugs and reduced levels of active agents in target cells. The latter can be due to lower drug uptake, increased export or decreased intracellular proportion of active/inactive agent due to changes in the expression/function of enzymes responsible for the activation of pro-drugs and the inactivation of active agents. Characterization of the "resistome", or profile of expressed genes accounting for multi-drug resistance (MDR) phenotype, would permit to predict the lack of response to chemotherapy and would help in the selection of the best pharmacological regime for each patient and moment, and to develop strategies of chemosensitization.
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20
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Role of Genetic Polymorphisms of Deoxycytidine Kinase and Cytidine Deaminase to Predict Risk of Death in Children with Acute Myeloid Leukemia. BIOMED RESEARCH INTERNATIONAL 2015; 2015:309491. [PMID: 26090398 PMCID: PMC4450239 DOI: 10.1155/2015/309491] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 09/02/2014] [Accepted: 09/10/2014] [Indexed: 11/17/2022]
Abstract
Cytarabine is one of the most effective antineoplastic agents among those used for the treatment of acute myeloid leukemia. However, some patients develop resistance and/or severe side effects to the drug, which may interfere with the efficacy of the treatment. The polymorphisms of some Ara-C metabolizing enzymes seem to affect outcome and toxicity in AML patients receiving cytarabine. We conducted this study in a cohort of Mexican pediatric patients with AML to investigate whether the polymorphisms of the deoxycytidine kinase and cytidine deaminase enzymes are implicated in clinical response and toxicity. Bone marrow and/or peripheral blood samples obtained at diagnosis from 27 previously untreated pediatric patients with de novo AML were processed for genotyping and in vitro chemosensitivity assay, and we analyzed the impact of genotypes and in vitro sensitivity on disease outcome and toxicity. In the multivariate Cox regression analysis, we found that age at diagnosis, wild-type genotype of the CDA A79C polymorphism, and wild-type genotype of the dCK C360G polymorphism were the most significant prognostic factors for predicting the risk of death.
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21
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Gabor KM, Schermann G, Lautner-Csorba O, Rarosi F, Erdelyi DJ, Endreffy E, Berek K, Bartyik K, Bereczki C, Szalai C, Semsei AF. Impact of single nucleotide polymorphisms of cytarabine metabolic genes on drug toxicity in childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 2015; 62:622-8. [PMID: 25557962 DOI: 10.1002/pbc.25379] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 11/05/2014] [Indexed: 11/05/2022]
Abstract
BACKGROUND Cytarabine (cytosine arabinoside, ara-C) is a chemotherapeutical agent used in the treatment of pediatric acute lymphoblastic leukemia (ALL). Adverse drug reactions, such as interpatient variability in sensitivity to ara-C, are considerable and may cause difficulties during chemotherapy. Single nucleotide polymorphisms (SNPs) can play a significant role in modifying nucleoside-drug pharmacokinetics and pharmacodynamics and thus the development of adverse effects. Our aim was to determine whether polymorphisms in genes encoding transporters and enzymes responsible for the metabolism of ara-C are associated with toxicity and clinical outcome in a patient population with childhood ALL. PROCEDURE We studied 8 SNPs in the CDA, DCK, DCTD, SLC28A3, and SLC29A1 genes in 144 patients with childhood acute lymphoblastic leukemia treated according to ALLIC BFM 1990, 1995 and 2002 protocols. RESULTS DCK rs12648166 and DCK rs4694362 SNPs were associated with hematologic toxicity (OR = 2.63, CI 95% = 1.37-5.04, P = 0.0036 and OR = 2.53, CI 95% = 1.34-4.80, P = 0.0044, respectively). CONCLUSIONS Our results indicate that DCK polymorphisms might be important genetic risk factors for hematologic toxicity during ALL treatment with ara-C. Individualized chemotherapy based on genetic profiling may help to optimize ara-C dosing, leading to improvements in clinical outcome and reduced toxicity.
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Affiliation(s)
- Krisztina Mita Gabor
- Department of Pediatrics and Pediatric Health Care Center, Faculty of Medicine, University of Szeged, Hungary
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22
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Amaki J, Onizuka M, Ohmachi K, Aoyama Y, Hara R, Ichiki A, Kawai H, Sato A, Miyamoto M, Toyosaki M, Machida S, Kojima M, Shirasugi Y, Kawada H, Ogawa Y, Ando K. Single nucleotide polymorphisms of cytarabine metabolic genes influence clinical outcome in acute myeloid leukemia patients receiving high-dose cytarabine therapy. Int J Hematol 2015; 101:543-53. [DOI: 10.1007/s12185-015-1766-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 02/23/2015] [Accepted: 02/23/2015] [Indexed: 03/02/2023]
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23
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Serdjebi C, Milano G, Ciccolini J. Role of cytidine deaminase in toxicity and efficacy of nucleosidic analogs. Expert Opin Drug Metab Toxicol 2014; 11:665-72. [PMID: 25495470 DOI: 10.1517/17425255.2015.985648] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Nucleosidic analogs such as pyrimidine and purine derivatives are mainstay in the field of treating cancers, both in adults and in children. All these drugs act as antimetabolite compounds, that is, they interfere with the ability of cancer cells to synthesize the nucleosides or the nucleotides necessary for proliferation and progression. As with most cytotoxics, maintaining patients in their therapeutic window is challenging, and predicting changes in drug exposure is critical to ensure an optimal efficacy/toxicity balance. AREAS COVERED Among the antimetabolites, a small but widely prescribed number of drugs (i.e., gemcitabine, capecitabine, cytarabine, azacytidine) share a same metabolic pattern driven by a liver enzyme, cytidine deaminase (CDA), coded by a gene displaying several genetic and epigenetic polymorphisms. Consequently, CDA activity is erratic, ranging from deficient to ultra-rapid deaminator patients, with subsequent impact on drug pharmacokinetics and pharmacodynamics eventually. This review provides an update on the variety of clinical studies and case-reports investigating on CDA status as a marker for clinical outcome in cancer patients treated with nucleosidic analogs. EXPERT OPINION Whereas sorting patients on the basis of their CDA genotype remains tricky because of unclear genotype-to-phenotype relationships, developing functional strategies (i.e., phenotype-based status determination) could help to use CDA status as a biomarker for developing adaptive dosing strategies with nucleosidic analogs.
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Affiliation(s)
- Cindy Serdjebi
- INSERM UMR_S911 Aix-Marseille University, SMARTc, CRO2, Pharmacokinetics Unit , UFR Pharmacie 27 Bd Jean Moulin 13385 Marseille , France
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24
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Wan H, Zhu J, Chen F, Xiao F, Huang H, Han X, Zhong L, Zhong H, Xu L, Ni B, Zhong J. SLC29A1 single nucleotide polymorphisms as independent prognostic predictors for survival of patients with acute myeloid leukemia: an in vitro study. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2014; 33:90. [PMID: 25398670 PMCID: PMC4234887 DOI: 10.1186/s13046-014-0090-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 10/20/2014] [Indexed: 12/12/2022]
Abstract
Background The mechanism behind poor survival of acute myeloid leukemia (AML) patients with 1-barabinofuranosylcytosine (Ara-C) based treatment remains unclear. This study aimed to assess the pharmacogenomic effects of Ara-C metabolic pathway in patients with AML. Methods The genotypes of 19 single nucleotide polymorphisms (SNPs) of DCK, CDA and SLC29A1from 100 AML patients treated with Ara-C were examined. All the SNPs were screened with ligase detection reaction assay. The transcription analysis of genes was examined by quantitative real time polymerase chain reaction. The association between clinical outcome and gene variants was evaluated by Kaplan-Meier method. Results Genotypes of rs9394992 and rs324148 for SLC29A1 in remission patients were significantly different from those in relapsed ones. Post-induction overall survival (OS) significantly decreased in patients with the CC genotype of rs324148 compared with CT and TT genotypes (hazard ratio [HR] = 2.997 [95% confidence interval (CI): 1.71-5.27]). As compared with CT and TT genotype, patients with the CC genotype of rs9394992 had longer survival time (HR = 0.25 [95% CI: 0.075-0.81]; HR = 0.43 [95% CI: 0.24-0.78]) and longer disease-free survival (DFS) (HR = 0.52 [95% CI: 0.29-0.93]; HR = 0.15 [95% CI: 0.05-0.47]) as well As compared with CT and TT genotype, patients with the CC genotype of rs324148 had shorter DFS (HR = 3.18 [95% CI: 1.76-5.76]). Additionally, patients with adverse karyotypes had shorter DFS (HR = 0.17 [95% CI: 0.05-0.54]) and OS (HR = 0.18 [95% CI: 0.05-0.68]). Conclusions AML patients with low activity of SLC29A1 genotype have shorter DFS and OS in Ara-C based therapy. Genotypes of rs9394992 and rs324148 may be independent prognostic predictors for the survival of AML patients. Electronic supplementary material The online version of this article (doi:10.1186/s13046-014-0090-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Haixia Wan
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
| | - Jianyi Zhu
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
| | - Fangyuan Chen
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
| | - Fei Xiao
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
| | - Honghui Huang
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
| | - Xiaofeng Han
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
| | - Lu Zhong
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
| | - Hua Zhong
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
| | - Lan Xu
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
| | - Beiwen Ni
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
| | - Jihua Zhong
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
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25
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Jakobsen Falk I, Fyrberg A, Paul E, Nahi H, Hermanson M, Rosenquist R, Höglund M, Palmqvist L, Stockelberg D, Wei Y, Gréen H, Lotfi K. Impact of ABCB1 single nucleotide polymorphisms 1236C>T and 2677G>T on overall survival in FLT3 wild-type de novo AML patients with normal karyotype. Br J Haematol 2014; 167:671-80. [PMID: 25155901 DOI: 10.1111/bjh.13097] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 07/02/2014] [Indexed: 01/11/2023]
Abstract
Drug resistance is a clinically relevant problem in the treatment of acute myeloid leukaemia (AML). We have previously reported a relationship between single nucleotide polymorphisms (SNPs) of ABCB1, encoding the multi-drug transporter P-glycoprotein, and overall survival (OS) in normal karyotype (NK)-AML. Here we extended this material, enabling subgroup analysis based on FLT3 and NPM1 status, to further elucidate the influence of ABCB1 SNPs. De novo NK-AML patients (n = 201) were analysed for 1199G>A, 1236C>T, 2677G>T/A and 3435C>T, and correlations to outcome were investigated. FLT3 wild-type 1236C/C patients have significantly shorter OS compared to patients carrying the variant allele; medians 20 vs. 49 months, respectively, P = 0·017. There was also an inferior outcome in FLT3 wild-type 2677G/G patients compared to patients carrying the variant allele, median OS 20 vs. 35 months, respectively, P = 0·039. This was confirmed in Cox regression analysis. Our results indicate that ABCB1 1236C>T and 2677G>T may be used as prognostic markers to distinguish relatively high risk patients in the intermediate risk FLT3 wild-type group, which may contribute to future individualizing of treatment strategies.
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Affiliation(s)
- Ingrid Jakobsen Falk
- Clinical Pharmacology, Division of Drug Research, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden
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