The present study aimed to identify polymorphic genes encoding carbonyl reductases (CBR1, CBR3) and investigate their influence on doxorubicin disposition in Asian breast cancer patients (n = 62). Doxorubicin (60 mg/m 2 ) was administered every 3 weeks for four to six cycles and the pharmacokinetic parameters were estimated using non-compartmental analysis (WinNonlin). The Mann-Whitney U-test was used to assess genotypic-phenotypic correlations. (1) The phase I and II enzymes are expressed abundantly in hepatic tissues and display large interindividual variations in their metabolic capacities toward a wide array of therapeutic agents.The CBR are ubiquitously expressed monomeric NADPHdependent cytosolic enzymes that catalyze the reduction of chemically diverse substrates such as aldehydes, ketones, quinones, and other xenobiotics.(2,3) Apart from the metabolism of endogenous compounds and drug detoxification, CBR are also assumed to participate in cellular processes such as signal transduction, (4) apoptosis,mutagenesis,carcinogenesis,and drug resistance.(8) Four CBR isoforms (CBR1, CBR2, CBR3, and CBR4) that were initially assigned to the aldo-keto reductase (AKR) family are now classified under the family of short-chain dehydrogenases and represent one of the largest protein families identified to date.(9) CBR1 is the major carbonyl reductase and is expressed widely in different tissues. The CBR1 gene is mapped to chromosome 21q22.12, has three exons spanning 3.3 kb, and encodes a 30-kDa monomeric protein comprising 277 amino acids. The CBR1 gene lacks a CAAT and TATA box and contains a GC-rich island extending into the first exon, a structure characteristic of genes having a housekeeping function.(4) The identified substrates of human CBR1 include endogenous compounds (prostaglandins and steroids) and drugs such as loxoprofen, (4) metyrapone, (10) haloperidol, (11) bromoperidol,timirepone, (13) and doxorubicin. (14) CBR2 has low sequence identity with CBR1 and has not been identified in human tissues. The CBR3 gene contains three exons spanning a region of 11.2 kb and has a 72% sequence similarity with CBR1. It is located 62 kb telomeric to the CBR1 gene. Although widely expressed, the relative expression of CBR3 is much lower than CBR1 in most of the tissues analyzed.(15) The CBR4 gene is located on human chromosome 4 (4q32.3) and encodes a protein composed of 237 amino acids, but its enzymatic properties and tissue distribution remain unknown. (15) To date, there are limited studies investigating the influence of genetic polymorphisms in the CBR genes on the pharmacokinetics and pharmacodynamics of drugs. Avramopoulos et al. identified the CBR1 3′-untranslated region (UTR) G>A transition for the linkage mapping of the CBR gene on chromosome 21. (16) However, the effect of the polymorphism on enzyme activity and tissue expression is not known. Gonzalez-Covarrubias et al. reported the V88I (262G>A, rs1143663), L73L (312G>C, rs25678), A209A (720C>T, rs20572), and V231V (786G>A, rs2230192) polymorphisms by scree...