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Rutherford DV, Medley S, Henderson NC, Gersch CL, Vandenberg TA, Albain KS, Dakhil SR, Tirumali NR, Gralow JR, Hortobagyi GN, Pusztai L, Mehta RS, Hayes DF, Kidwell KM, Henry NL, Barlow WE, Rae JM, Hertz DL. Effects of CYP3A4 and CYP2C9 genotype on systemic anastrozole and fulvestrant concentrations in SWOG S0226. Pharmacogenomics 2023; 24:665-673. [PMID: 37615099 PMCID: PMC10565537 DOI: 10.2217/pgs-2023-0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/31/2023] [Indexed: 08/25/2023] Open
Abstract
Objective & methods: This study tested associations of genotype-predicted activity of CYP3A4, other pharmacogenes, SLC28A7 (rs11648166) and ALPPL2 (rs28845026) with systemic concentrations of the endocrine therapies anastrozole and fulvestrant in SWOG S0226 trial participants. Results: Participants in the anastrozole-only arm with low CYP3A4 activity (i.e. CYP3A4*22 carriers) had higher systemic anastrozole concentrations than patients with high CYP3A4 activity (β-coefficient = 10.03; 95% CI: 1.42, 18.6; p = 0.025). In an exploratory analysis, participants with low CYP2C9 activity had lower anastrozole concentrations and higher fulvestrant concentrations than participants with high CYP2C9 activity. Conclusion: Inherited genetic variation in CYP3A4 and CYP2C9 may affect concentrations of endocrine therapy and may be useful to personalize dosing and improve treatment outcomes.
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Affiliation(s)
- Delaney V Rutherford
- Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Sarah Medley
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Nicholas C Henderson
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Christina L Gersch
- Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Ted A Vandenberg
- Western University/Canadian Cancer Trials Group, London, ON, N5X 3K8, Canada
| | - Kathy S Albain
- Loyola University Chicago Stritch School of Medicine, Maywood, IL 60153, USA
| | | | | | - Julie R Gralow
- American Society of Clinical Oncology, Alexandria, 22314, Virginia
| | | | | | - Rita S Mehta
- University of California Irvine Medical Center, Chao Family Comprehensive Cancer Center, Orange, CA 92868, USA
| | - Daniel F Hayes
- Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Kelley M Kidwell
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - N Lynn Henry
- Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | | | - James M Rae
- Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Daniel L Hertz
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI 48109, USA
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Mehta RS, Barlow WE, Albain KS, Vandenberg TA, Dakhil SR, Tirumali NR, Lew DL, Hayes DF, Gralow JR, Linden HH, Livingston RB, Hortobagyi GN. Overall Survival with Fulvestrant plus Anastrozole in Metastatic Breast Cancer. N Engl J Med 2019; 380:1226-1234. [PMID: 30917258 PMCID: PMC6885383 DOI: 10.1056/nejmoa1811714] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND We previously reported prolonged progression-free survival and marginally prolonged overall survival among postmenopausal patients with hormone receptor-positive metastatic breast cancer who had been randomly assigned to receive the aromatase inhibitor anastrozole plus the selective estrogen-receptor down-regulator fulvestrant, as compared with anastrozole alone, as first-line therapy. We now report final survival outcomes. METHODS We randomly assigned patients to receive either anastrozole or fulvestrant plus anastrozole. Randomization was stratified according to adjuvant tamoxifen use. Analysis of survival was performed by means of two-sided stratified log-rank tests and Cox regression. Efficacy and safety were compared between the two groups, both overall and in subgroups. RESULTS Of 707 patients who had undergone randomization, 694 had data available for analysis. The combination-therapy group had 247 deaths among 349 women (71%) and a median overall survival of 49.8 months, as compared with 261 deaths among 345 women (76%) and a median overall survival of 42.0 months in the anastrozole-alone group, a significant difference (hazard ratio for death, 0.82; 95% confidence interval [CI], 0.69 to 0.98; P = 0.03 by the log-rank test). In a subgroup analysis of the two strata, overall survival among women who had not received tamoxifen previously was longer with the combination therapy than with anastrozole alone (median, 52.2 months and 40.3 months, respectively; hazard ratio, 0.73; 95% CI, 0.58 to 0.92); among women who had received tamoxifen previously, overall survival was similar in the two groups (median, 48.2 months and 43.5 months, respectively; hazard ratio, 0.97; 95% CI, 0.74 to 1.27) (P = 0.09 for interaction). The incidence of long-term toxic effects of grade 3 to 5 was similar in the two groups. Approximately 45% of the patients in the anastrozole-alone group crossed over to receive fulvestrant. CONCLUSIONS The addition of fulvestrant to anastrozole was associated with increased long-term survival as compared with anastrozole alone, despite substantial crossover to fulvestrant after progression during therapy with anastrozole alone. The results suggest that the benefit was particularly notable in patients without previous exposure to adjuvant endocrine therapy. (Funded by the National Cancer Institute and AstraZeneca; ClinicalTrials.gov number, NCT00075764.).
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Affiliation(s)
- Rita S Mehta
- From the Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange (R.S.M.); the SWOG Statistics and Data Management Center (W.E.B., D.L.L.) and Seattle Cancer Care Alliance and University of Washington Medical Center (J.R.G., H.H.L.) - both in Seattle; Loyola University Chicago Stritch School of Medicine, Maywood, IL (K.S.A.); London Health Sciences Centre and the National Cancer Institute of Canada Clinical Trials Group, London, ON, Canada (T.A.V.); the Cancer Center of Kansas and Wichita National Cancer Institute Community Oncology Research Program (NCORP), Wichita (S.R.D.); Kaiser Permanente NCORP, Portland, OR (N.R.T.); the University of Michigan, Ann Arbor (D.F.H.); the University of Arizona Cancer Center, Tucson (R.B.L.); and the University of Texas M.D. Anderson Cancer Center, Houston (G.N.H.)
| | - William E Barlow
- From the Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange (R.S.M.); the SWOG Statistics and Data Management Center (W.E.B., D.L.L.) and Seattle Cancer Care Alliance and University of Washington Medical Center (J.R.G., H.H.L.) - both in Seattle; Loyola University Chicago Stritch School of Medicine, Maywood, IL (K.S.A.); London Health Sciences Centre and the National Cancer Institute of Canada Clinical Trials Group, London, ON, Canada (T.A.V.); the Cancer Center of Kansas and Wichita National Cancer Institute Community Oncology Research Program (NCORP), Wichita (S.R.D.); Kaiser Permanente NCORP, Portland, OR (N.R.T.); the University of Michigan, Ann Arbor (D.F.H.); the University of Arizona Cancer Center, Tucson (R.B.L.); and the University of Texas M.D. Anderson Cancer Center, Houston (G.N.H.)
| | - Kathy S Albain
- From the Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange (R.S.M.); the SWOG Statistics and Data Management Center (W.E.B., D.L.L.) and Seattle Cancer Care Alliance and University of Washington Medical Center (J.R.G., H.H.L.) - both in Seattle; Loyola University Chicago Stritch School of Medicine, Maywood, IL (K.S.A.); London Health Sciences Centre and the National Cancer Institute of Canada Clinical Trials Group, London, ON, Canada (T.A.V.); the Cancer Center of Kansas and Wichita National Cancer Institute Community Oncology Research Program (NCORP), Wichita (S.R.D.); Kaiser Permanente NCORP, Portland, OR (N.R.T.); the University of Michigan, Ann Arbor (D.F.H.); the University of Arizona Cancer Center, Tucson (R.B.L.); and the University of Texas M.D. Anderson Cancer Center, Houston (G.N.H.)
| | - Ted A Vandenberg
- From the Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange (R.S.M.); the SWOG Statistics and Data Management Center (W.E.B., D.L.L.) and Seattle Cancer Care Alliance and University of Washington Medical Center (J.R.G., H.H.L.) - both in Seattle; Loyola University Chicago Stritch School of Medicine, Maywood, IL (K.S.A.); London Health Sciences Centre and the National Cancer Institute of Canada Clinical Trials Group, London, ON, Canada (T.A.V.); the Cancer Center of Kansas and Wichita National Cancer Institute Community Oncology Research Program (NCORP), Wichita (S.R.D.); Kaiser Permanente NCORP, Portland, OR (N.R.T.); the University of Michigan, Ann Arbor (D.F.H.); the University of Arizona Cancer Center, Tucson (R.B.L.); and the University of Texas M.D. Anderson Cancer Center, Houston (G.N.H.)
| | - Shaker R Dakhil
- From the Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange (R.S.M.); the SWOG Statistics and Data Management Center (W.E.B., D.L.L.) and Seattle Cancer Care Alliance and University of Washington Medical Center (J.R.G., H.H.L.) - both in Seattle; Loyola University Chicago Stritch School of Medicine, Maywood, IL (K.S.A.); London Health Sciences Centre and the National Cancer Institute of Canada Clinical Trials Group, London, ON, Canada (T.A.V.); the Cancer Center of Kansas and Wichita National Cancer Institute Community Oncology Research Program (NCORP), Wichita (S.R.D.); Kaiser Permanente NCORP, Portland, OR (N.R.T.); the University of Michigan, Ann Arbor (D.F.H.); the University of Arizona Cancer Center, Tucson (R.B.L.); and the University of Texas M.D. Anderson Cancer Center, Houston (G.N.H.)
| | - Nagendra R Tirumali
- From the Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange (R.S.M.); the SWOG Statistics and Data Management Center (W.E.B., D.L.L.) and Seattle Cancer Care Alliance and University of Washington Medical Center (J.R.G., H.H.L.) - both in Seattle; Loyola University Chicago Stritch School of Medicine, Maywood, IL (K.S.A.); London Health Sciences Centre and the National Cancer Institute of Canada Clinical Trials Group, London, ON, Canada (T.A.V.); the Cancer Center of Kansas and Wichita National Cancer Institute Community Oncology Research Program (NCORP), Wichita (S.R.D.); Kaiser Permanente NCORP, Portland, OR (N.R.T.); the University of Michigan, Ann Arbor (D.F.H.); the University of Arizona Cancer Center, Tucson (R.B.L.); and the University of Texas M.D. Anderson Cancer Center, Houston (G.N.H.)
| | - Danika L Lew
- From the Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange (R.S.M.); the SWOG Statistics and Data Management Center (W.E.B., D.L.L.) and Seattle Cancer Care Alliance and University of Washington Medical Center (J.R.G., H.H.L.) - both in Seattle; Loyola University Chicago Stritch School of Medicine, Maywood, IL (K.S.A.); London Health Sciences Centre and the National Cancer Institute of Canada Clinical Trials Group, London, ON, Canada (T.A.V.); the Cancer Center of Kansas and Wichita National Cancer Institute Community Oncology Research Program (NCORP), Wichita (S.R.D.); Kaiser Permanente NCORP, Portland, OR (N.R.T.); the University of Michigan, Ann Arbor (D.F.H.); the University of Arizona Cancer Center, Tucson (R.B.L.); and the University of Texas M.D. Anderson Cancer Center, Houston (G.N.H.)
| | - Daniel F Hayes
- From the Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange (R.S.M.); the SWOG Statistics and Data Management Center (W.E.B., D.L.L.) and Seattle Cancer Care Alliance and University of Washington Medical Center (J.R.G., H.H.L.) - both in Seattle; Loyola University Chicago Stritch School of Medicine, Maywood, IL (K.S.A.); London Health Sciences Centre and the National Cancer Institute of Canada Clinical Trials Group, London, ON, Canada (T.A.V.); the Cancer Center of Kansas and Wichita National Cancer Institute Community Oncology Research Program (NCORP), Wichita (S.R.D.); Kaiser Permanente NCORP, Portland, OR (N.R.T.); the University of Michigan, Ann Arbor (D.F.H.); the University of Arizona Cancer Center, Tucson (R.B.L.); and the University of Texas M.D. Anderson Cancer Center, Houston (G.N.H.)
| | - Julie R Gralow
- From the Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange (R.S.M.); the SWOG Statistics and Data Management Center (W.E.B., D.L.L.) and Seattle Cancer Care Alliance and University of Washington Medical Center (J.R.G., H.H.L.) - both in Seattle; Loyola University Chicago Stritch School of Medicine, Maywood, IL (K.S.A.); London Health Sciences Centre and the National Cancer Institute of Canada Clinical Trials Group, London, ON, Canada (T.A.V.); the Cancer Center of Kansas and Wichita National Cancer Institute Community Oncology Research Program (NCORP), Wichita (S.R.D.); Kaiser Permanente NCORP, Portland, OR (N.R.T.); the University of Michigan, Ann Arbor (D.F.H.); the University of Arizona Cancer Center, Tucson (R.B.L.); and the University of Texas M.D. Anderson Cancer Center, Houston (G.N.H.)
| | - Hannah H Linden
- From the Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange (R.S.M.); the SWOG Statistics and Data Management Center (W.E.B., D.L.L.) and Seattle Cancer Care Alliance and University of Washington Medical Center (J.R.G., H.H.L.) - both in Seattle; Loyola University Chicago Stritch School of Medicine, Maywood, IL (K.S.A.); London Health Sciences Centre and the National Cancer Institute of Canada Clinical Trials Group, London, ON, Canada (T.A.V.); the Cancer Center of Kansas and Wichita National Cancer Institute Community Oncology Research Program (NCORP), Wichita (S.R.D.); Kaiser Permanente NCORP, Portland, OR (N.R.T.); the University of Michigan, Ann Arbor (D.F.H.); the University of Arizona Cancer Center, Tucson (R.B.L.); and the University of Texas M.D. Anderson Cancer Center, Houston (G.N.H.)
| | - Robert B Livingston
- From the Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange (R.S.M.); the SWOG Statistics and Data Management Center (W.E.B., D.L.L.) and Seattle Cancer Care Alliance and University of Washington Medical Center (J.R.G., H.H.L.) - both in Seattle; Loyola University Chicago Stritch School of Medicine, Maywood, IL (K.S.A.); London Health Sciences Centre and the National Cancer Institute of Canada Clinical Trials Group, London, ON, Canada (T.A.V.); the Cancer Center of Kansas and Wichita National Cancer Institute Community Oncology Research Program (NCORP), Wichita (S.R.D.); Kaiser Permanente NCORP, Portland, OR (N.R.T.); the University of Michigan, Ann Arbor (D.F.H.); the University of Arizona Cancer Center, Tucson (R.B.L.); and the University of Texas M.D. Anderson Cancer Center, Houston (G.N.H.)
| | - Gabriel N Hortobagyi
- From the Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange (R.S.M.); the SWOG Statistics and Data Management Center (W.E.B., D.L.L.) and Seattle Cancer Care Alliance and University of Washington Medical Center (J.R.G., H.H.L.) - both in Seattle; Loyola University Chicago Stritch School of Medicine, Maywood, IL (K.S.A.); London Health Sciences Centre and the National Cancer Institute of Canada Clinical Trials Group, London, ON, Canada (T.A.V.); the Cancer Center of Kansas and Wichita National Cancer Institute Community Oncology Research Program (NCORP), Wichita (S.R.D.); Kaiser Permanente NCORP, Portland, OR (N.R.T.); the University of Michigan, Ann Arbor (D.F.H.); the University of Arizona Cancer Center, Tucson (R.B.L.); and the University of Texas M.D. Anderson Cancer Center, Houston (G.N.H.)
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Hertz DL, Barlow WE, Kidwell KM, Albain KS, Vandenberg TA, Dakhil SR, Tirumali NR, Livingston RB, Gralow J, Hayes DF, Hortobagyi GN, Mehta RS, Rae JM. Fulvestrant decreases anastrozole drug concentrations when taken concurrently by patients with metastatic breast cancer treated on SWOG study S0226. Br J Clin Pharmacol 2016; 81:1134-41. [PMID: 26859101 PMCID: PMC4876171 DOI: 10.1111/bcp.12904] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 01/25/2016] [Accepted: 02/03/2016] [Indexed: 11/29/2022] Open
Abstract
AIMS In the SWOG S0226 trial the combination of anastrozole plus fulvestrant (n = 349) was superior to anastrozole alone (n = 345) in hormone receptor (HR)-positive metastatic breast cancer. Here we report a pharmacokinetic subset analysis investigating a possible drug interaction between anastrozole and fulvestrant. METHODS Post-menopausal patients with HR-positive metastatic breast cancer were randomized to anastrozole with or without concurrent fulvestrant. Blood samples were collected at 2, 4, 6 and 8 months, just prior to receiving the next dose of anastrozole and fulvestrant. Drug concentrations were measured via LC/MS-MS. Anastrozole concentration was compared in patients on anastrozole alone vs. patients on concomitant fulvestrant. Comparisons were made at each time point using parametric tests and over time using a linear mixed effects model. RESULTS A total of 483 anastrozole concentration measurements were included, 224 samples from 64 patients on the anastrozole alone arm and 259 from 73 patients on the combination arm. The mean anastrozole concentration in the combination arm was significantly lower than that in the anastrozole alone arm at each sample collection time (all P < 0.01) and in the mixed effects model (an estimated difference of 9.85 ng ml(-1) (95% CI 5.69, 14.00 ng ml(-1) ), P < 0.001). CONCLUSION A significant pharmacokinetic drug interaction was detected, in which the addition of fulvestrant to anastrozole treatment decreased the trough anastrozole concentration. Further research is needed to verify whether this interaction affects treatment efficacy and to determine the pharmacological mechanism by which this interaction occurs.
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Affiliation(s)
- Daniel L Hertz
- College of Pharmacy, University of Michigan, Ann Arbor, MI, USA
| | | | - Kelley M Kidwell
- University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Kathy S Albain
- Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Ted A Vandenberg
- London Health Sciences Center/National Cancer Institute of Canada Clinical, Trials Group, London, ON, Canada
| | | | | | | | - Julie Gralow
- Seattle Cancer Care Alliance, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
| | - Daniel F Hayes
- Division of Hematology/Oncology, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA
| | | | - Rita S Mehta
- University of California Irvine Medical Center, Chao Family Comprehensive, Cancer Center, Orange, CA, USA
| | - James M Rae
- Division of Hematology/Oncology, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA
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4
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Kadlubar SA, Barlow WE, Mehta RS, Daniels JR, Albain KS, Vandengerg TA, Dakhil SR, Tirumali NR, Lew DL, Gralow JR, Livingston RB, Hortobagiyi GN, Hayes DF, Rae JM. Abstract P3-07-64: Association between gene variants in SULT1A1 and UGT1A4 and disease outcomes in patients enrolled in SWOG S0226 and treated with anastrozole alone or in combination with fulvestrant for metastatic breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-07-64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Anastrozole (A) blocks estrogen production by inhibiting the activity of CYP19 aromatase. Fulvestrant (F) blocks estrogen receptor (ER) signaling by competitive binding, leading to ER degradation by ubiquitination. SWOG S0226 ("Phase III Randomized Trial of Anastrozole versus Anastrozole and Fulvestrant (250mg LD) as First Line Therapy for Post Menopausal Women with Metastatic Breast Cancer," ClinicalTrials.gov Identifier:NCT00075764) demonstrated that combination of A+F is superior to A alone as first-line therapy for patients with ER positive metastatic breast cancer (Mehta et al, NEJM, 2012). Our functional preclinical studies have shown that single nucleotide polymorphisms (SNPs) in SULT1A1 and UGT1A4, drug conjugation enzymes that inactivate A and F, result in decreased enzyme activity toward these drugs (Edavana et al, DMD, 2013; Edavana et al Pharmgenomics Pers Med 2013). We therefore hypothesized that these SNPs will be associated with disease outcomes in S0226 patients due to altered drug levels.
Methods: Germline DNA was available for 295 (43.5%) patients enrolled in S0226 overall (157 on A and 138 on A+F). SNPs in SULT1A1 and UGT1A4 were determined either by direct sequencing or allele-specific PCR (TaqMan) assays.
Results: There was no difference in progression-free survival (PFS) or overall survival (OS) comparing patients with or without available germline DNA (p = 0.86 and 0.36, respectively). The SULT1A1 G902A allele (rs6839), which confers decreased mRNA and enzymatic activity, was associated with improved PFS (GG/GA vs. AA; HR 0.74, 95% CI 0.56-0.98, p=0.033) and OS (HR 0.70, 95% 0.50-0.98, p=0.039). In exploratory subset analyses of PFS, the SULT1A1 G902A association was similar across both treatment arms (A HR=0.75; 95% CI 0.51-1.10; A+F HR=0.73; 95% CI 0.48-1.11). For OS there was some evidence of a difference by treatment (A HR=0.60; 95% CI 0.38-0.96; A+F HR=0.82; 95% CI 0.50-1.32), though no significant interaction was evident (p=0.30).
The UGT1A4 G-163A promoter variant, which leads to decreased protein expression, was not associated with PFS (AA/AG vs. GG HR 0.88, 95% CI 0.68-1.14, p=0.33); however, this variant was associated with OS (HR 0.71, 95% CI 0.52-0.96, p=0.027). In subset analyses with OS, the difference was marginally stronger in the A arm (HR 0.63, 95% CI 0.42-0.97, p=0.035) compared to the A+F arm (HR 0.77, 95% CI 0.49-1.21, p=0.25), though the interaction was not significant (p=0.40).
Conclusion: SULT1A1 and UGT1A4 gene variants resulting in decreased enzyme activity were associated with better PFS, OS or both in patients enrolled in SWOG S0226. Planned validation studies correlating these SNPs with drug levels and disease outcomes in additional patient cohorts will establish their clinical utility in identifying patients who benefit from A and F alone or in combination.
Funding: Supported by NIH/NCI CA118981; NIH/NCI/NCTN grants CA180888, CA180819, and CA180863; and in part by AstraZeneca.
Citation Format: Kadlubar SA, Barlow WE, Mehta RS, Daniels JR, Albain KS, Vandengerg TA, Dakhil SR, Tirumali NR, Lew DL, Gralow JR, Livingston RB, Hortobagiyi GN, Hayes DF, Rae JM. Association between gene variants in SULT1A1 and UGT1A4 and disease outcomes in patients enrolled in SWOG S0226 and treated with anastrozole alone or in combination with fulvestrant for metastatic breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-07-64.
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Affiliation(s)
- SA Kadlubar
- University of Arkansas Medical Sciences; Fred Hutchinson Cancer Research Center; LUMC; LHSC; U Michigan; CCk; KP
| | - WE Barlow
- University of Arkansas Medical Sciences; Fred Hutchinson Cancer Research Center; LUMC; LHSC; U Michigan; CCk; KP
| | - RS Mehta
- University of Arkansas Medical Sciences; Fred Hutchinson Cancer Research Center; LUMC; LHSC; U Michigan; CCk; KP
| | - JR Daniels
- University of Arkansas Medical Sciences; Fred Hutchinson Cancer Research Center; LUMC; LHSC; U Michigan; CCk; KP
| | - KS Albain
- University of Arkansas Medical Sciences; Fred Hutchinson Cancer Research Center; LUMC; LHSC; U Michigan; CCk; KP
| | - TA Vandengerg
- University of Arkansas Medical Sciences; Fred Hutchinson Cancer Research Center; LUMC; LHSC; U Michigan; CCk; KP
| | - SR Dakhil
- University of Arkansas Medical Sciences; Fred Hutchinson Cancer Research Center; LUMC; LHSC; U Michigan; CCk; KP
| | - NR Tirumali
- University of Arkansas Medical Sciences; Fred Hutchinson Cancer Research Center; LUMC; LHSC; U Michigan; CCk; KP
| | - DL Lew
- University of Arkansas Medical Sciences; Fred Hutchinson Cancer Research Center; LUMC; LHSC; U Michigan; CCk; KP
| | - JR Gralow
- University of Arkansas Medical Sciences; Fred Hutchinson Cancer Research Center; LUMC; LHSC; U Michigan; CCk; KP
| | - RB Livingston
- University of Arkansas Medical Sciences; Fred Hutchinson Cancer Research Center; LUMC; LHSC; U Michigan; CCk; KP
| | - GN Hortobagiyi
- University of Arkansas Medical Sciences; Fred Hutchinson Cancer Research Center; LUMC; LHSC; U Michigan; CCk; KP
| | - DF Hayes
- University of Arkansas Medical Sciences; Fred Hutchinson Cancer Research Center; LUMC; LHSC; U Michigan; CCk; KP
| | - JM Rae
- University of Arkansas Medical Sciences; Fred Hutchinson Cancer Research Center; LUMC; LHSC; U Michigan; CCk; KP
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