Role of cytochrome P450 enzymes in the metabolism of antineoplastic drugs Cytochrome P450 enzymes are very important to metabolize anticarcinogenic agents. Therefore, understanding the role of these enzymes and their allele variants in the bioactivation or detoxification of drugs could greatly benefit antineoplastic pharmacotherapy. The aim of this manuscript is to give information about metabolizing enzymes for antineoplastic agents and to relate the current situation in antitumoral pharmacotherapy with recent knowledge about cytochrome P450 enzymes. This is crucial for the future perspectives towards personalized pharmacotherapy. We summarize the role of cytochrome P450 enzymes in the resistance and bioactivation of several antitumor agents, their induction and repression mechanisms and the effect of genetic polymorphisms on variability of drug metabolization. The understanding of genetic variability will help to develop new research lines on innovative therapeutic possibilities (

Frecuencia de los polimorfismos CYP1A1*2A y deleción del gen GSTM1 en pacientes con carcinoma de células escamosas de laringe en relación al hábito tabáquico: Estudio piloto en Chile Frequency of CYP1A1*2A and GSTM1 gene polymorphisms in Chilean patients with squamous cell carcinoma of the larynx in relation to smoking habit: a pilot study

BackgroundAccording to the latest NICE Guidelines for the management of type 2 diabetes, glucagon-like peptide 1 analogues (GLP-1) are indicated after failure of other therapies and should be considered ineffective in the absence of a metabolic response after 6 months of treatment.PurposeTo analyse the adequacy and effectiveness of liraglutide use in type 2 diabetes management in clinical practice.Material and methodsA retrospective study was conducted in diabetic patients who started treatment with liraglutide in 2013 in a health area comprising 450 000 inhabitants. Prescription data were obtained from the official prescription database (Microstrategy). Clinical data for assessing adequacy and effectiveness were obtained from medical records. It was considered appropriate to use liraglutide when basal HbA1c was ≥7.5%. Treatment was considered effective when HbA1c reduction was ≥1% 6 months after the start of therapy. The absence of HbA1c data was considered an inadequacy criterion. Effectiveness was evaluated only for those patients with analytical results. The percentage of patients in which the treatment was adequate, percentage of patients in which the treatment was effective and percentage of patients in which the treatment was withdrawn following lack of effectiveness were determined.ResultsDuring 2013, 82 patients began treatment with liraglutide. It was a suitable treatment in 55% of patients (n=45). Lack of analytical results for HbA1c led to the inadequacy criterion in 25 patients. Only 51 patients had analytical data to assess effectiveness. 45% (n=23) of patients had a reduction ≥1%, with a mean HbA1c reduction of 0.85% (95% CI 0.31 to 1.37). Treatment was continued for a year later despite being ineffective in 22 patients (79%).ConclusionLiraglutide use did not meet the criteria for adequacy for the indication in half of the patients. In more than half of the patients, liraglutide was ineffective in the metabolic control of type 2 diabetes. Despite the lack of effectiveness, liraglutide was continued in most patients.No conflict of interest