Association between the genetic polymorphisms of the pharmacokinetics of anthracycline drug and myelosuppression in a patient with breast cancer with anthracycline-based chemotherapy

Cui, Liqian; Huang, Jia; Zhan, Yongtao; Qiu, Ni; Jin, Huan; Li, Jia; Huang, Hao; Li, Hongsheng

doi:10.1016/j.lfs.2021.119392

Cited by 7 publications

(6 citation statements)

References 34 publications

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“…The relationship between CIL grade and survival could be explained by the pharmacokinetics (PK) and pharmacodynamics (PD) of chemotherapy [ 29 – 31 ]. Cui et al proposed that the PK of anthracycline may be individualized and associated with single-nucleotide polymorphisms (SNPs) [ 32 ]. Several studies have reported that the metabolism of paclitaxel and anthracyclines is catalyzed by cytochrome P450 (CYP450) enzymes, which were encoded by multiple families of CYP genes [ 33 – 37 ].…”

Section: Discussionmentioning

confidence: 99%

“Moderate” adjuvant chemotherapy-induced leukopenia is beneficial for survival of patients with early breast cancer: a retrospective study

Wang,

Jiang,

Wang

et al. 2023

BMC Cancer

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Background The association between chemotherapy-induced leukopenia (CIL) and survival for patients with early breast cancer (EBC) is not known. We investigated the relationship between different grades of CIL and survival in patients with EBC receiving adjuvant chemotherapy. Methods A total of 442 patients with EBC receiving a regimen containing an anthracycline (A) and taxane (T) were included into our analysis. Survival analyses were undertaken using Kaplan–Meier curves. The P-value was calculated using the log rank test. Subgroup analysis was conducted to investigate the correlation of CIL grade and survival based on the clinicopathological characteristics of patients. Afterwards, univariate and multivariate analyses screened out independent prognostic factors to construct a prognostic model, the robustness of which was verified. Results Patients with EBC who experienced grade 2–4 (“moderate” and “severe”) CIL were associated with longer overall survival (OS) than those with grade 0–1 (mild) CIL (P = 0.021). Compared with patients with mild CIL, OS was longer in patients with severe CIL (P = 0.029). Patients who suffered from moderate CIL tended to have longer OS than those with mild CIL (P = 0.082). Nevertheless, there was no distinguishable difference in OS between moderate- or severe-CIL groups. Subgroup analysis revealed that patients with moderate CIL had longer OS than those with mild CIL among patients who were premenstrual, or with human epidermal growth factor receptor 2-positive (HER2+), > 3 lymph nodes with metastases, a tumor diameter > 5 cm. A prognostic model based on menstrual status, N stage, and CIL grade showed satisfactory robustness. Conclusion The grade of CIL was strongly associated with the prognosis among patients with EBC who received a regimen containing both anthracyclines and taxanes. Patients with a “moderate” CIL grade tended to have better survival outcomes.

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Section: Discussionmentioning

confidence: 99%

“Moderate” adjuvant chemotherapy-induced leukopenia is beneficial for survival of patients with early breast cancer: a retrospective study

Wang,

Jiang,

Wang

et al. 2023

BMC Cancer

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“… 167 , 168 Recent data suggest that CBR1 rs20572 and AKR1A1 rs2088102 might be protective factors for the hematologic toxicity during anthracycline-based chemotherapy in breast cancer patients. 169 Unfortunately, rs20572 has a very low frequency among Africans, suggesting a possible, though not yet studied, explanation for the increased risk of hematologic toxicity in African patients. 169 Data on AKR1A1 rs2088102 among Africans have been reported to be 0.514.…”

Section: Anthracyclinesmentioning

confidence: 99%

“… 169 Unfortunately, rs20572 has a very low frequency among Africans, suggesting a possible, though not yet studied, explanation for the increased risk of hematologic toxicity in African patients. 169 Data on AKR1A1 rs2088102 among Africans have been reported to be 0.514. 92…”

Section: Anthracyclinesmentioning

confidence: 99%

Pharmacogenetics of Breast Cancer Treatments: A Sub-Saharan Africa Perspective

Nthontho¹,

Ndlovu²,

Sharma³

et al. 2022

PGPM

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Breast cancer is the most frequent cause of cancer death in low- and middle-income countries, in particular among sub-Saharan African women, where response to available anticancer treatment therapy is often limited by the recurrent breast tumours and metastasis, ultimately resulting in decreased overall survival rate. This can also be attributed to African genomes that contain more variation than those from other parts of the world. The purpose of this review is to summarize published evidence on pharmacogenetic and pharmacokinetic aspects related to specific available treatments and the known genetic variabilities associated with metabolism and/or transport of breast cancer drugs, and treatment outcomes when possible. The emphasis is on the African genetic variation and focuses on the genes with the highest strength of evidence, with a close look on CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP3A4/5, CYP19A1, UGT1A4, UGT2B7, UGT2B15, SLC22A16, SLC38A7, FcγR, DPYD, ABCB1 , and SULT1A1 , which are the genes known to play major roles in the metabolism and/or elimination of the respective anti-breast cancer drugs given to the patients. The genetic variability of their metabolism could be associated with different metabolic phenotypes that may cause reduced patients’ adherence because of toxicity or sub-therapeutic doses. Finally, this knowledge enhances possible personalized treatment approaches, with the possibility of improving survival outcomes in patients with breast cancer.

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“…Clinical meta-analysis studies show that the incidence of myelosuppression in breast cancer patients receiving anthracycline-based chemotherapy in western countries is around 80% (Cui L, et al ., 2021). In Asian early-stage breast cancer patients receiving anthracycline regimens, the incidence of grade 4 neutropenia and febrile neutropenia was 44.6% and 8.5% (Kim HS, et al ., 2016).…”

Section: Introductionsmentioning

confidence: 99%

“…Chemotherapy can suppress the hematopoietic system and damage the host cell protection mechanisms and cause myelosuppression (Carey, 2003). Grading criteria for hematologic toxicity caused by chemotherapy can be seen on Clinical meta-analysis studies show that the incidence of myelosuppression in breast cancer patients receiving anthracycline-based chemotherapy in western countries is around 80% (Cui L, et al, 2021). In Asian early-stage breast cancer patients receiving anthracycline regimens, the incidence of grade 4 neutropenia and febrile neutropenia was 44.6% and 8.5% (Kim HS, et al, 2016).…”

Section: Introductionsmentioning

confidence: 99%

ANALYSIS OF MYELOSUPPRESSION IN POST-CHEMOTHERAPY BREAST CANCER PATIENTS (A Study at Division of Hematology and Medical Oncology Airlangga University Hospital)

Yulistiani,

Utomo,

Romadhon

et al. 2024

Preprint

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Backgrounds Myelosuppression is decreased bone marrow activity that can be caused by chemotherapy which lowers the formation of blood cells and manifests as anaemia, neutropenia, leukopenia, and thrombocytopenia. Objective This study aims to analyze the post-chemotherapy myelosuppression in breast cancer patients and the chemotherapy regimen used during chemotherapy associated with blood parameters. Method This study was conducted in observational retrospective design. Data were taken from patients’ medical record that went on chemotherapy during January 2021- December 2022. Results The result showed that 97% patients had myelosuppression with the significance statistic’s analysis P<0,05. The chemotherapy regimens used in breast cancer patients are AC-T, TAC, Paclitaxel-Carboplatin, TC, AC-TH, and TCH. This study found myelosuppression in several regimens: anaemia grade I-II in patients with AC-T regimen, neutropenia grade I-IV in patients with TCH regimen, leukopenia grade I-IV in patients with TC regimen, and thrombocytopenia grade I in patients with Paclitaxel-Carboplatin regimen. The incidence of delayed chemotherapy in patients due to myelosuppression is 18%. Conclusion Based on this study, all the regimens used had myelosuppression side effect. The highest incidence of myelosuppression occurred in patient with TAC and TCH regimen. Myelosuppression can cause delayed therapy, dose reduction, and drug substitution.

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Association between the genetic polymorphisms of the pharmacokinetics of anthracycline drug and myelosuppression in a patient with breast cancer with anthracycline-based chemotherapy

Cited by 7 publications

References 34 publications

“Moderate” adjuvant chemotherapy-induced leukopenia is beneficial for survival of patients with early breast cancer: a retrospective study

“Moderate” adjuvant chemotherapy-induced leukopenia is beneficial for survival of patients with early breast cancer: a retrospective study

Pharmacogenetics of Breast Cancer Treatments: A Sub-Saharan Africa Perspective

ANALYSIS OF MYELOSUPPRESSION IN POST-CHEMOTHERAPY BREAST CANCER PATIENTS (A Study at Division of Hematology and Medical Oncology Airlangga University Hospital)

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