Cargando…
A multivariate analysis of genomic polymorphisms: prediction of clinical outcome to 5-FU/oxaliplatin combination chemotherapy in refractory colorectal cancer
In this marker evaluation study, we tested whether distinct patterns of functional genomic polymorphisms in genes involved in drug metabolic pathways and DNA repair that predict clinical outcome to 5-fluorouracil (5-FU)/oxaliplatin chemotherapy in patients with advanced colorectal cancer could be id...
Autores principales: | , , , , , , |
---|---|
Formato: | Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group
2004
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2409815/ https://www.ncbi.nlm.nih.gov/pubmed/15213713 http://dx.doi.org/10.1038/sj.bjc.6601975 |
_version_ | 1782155870173396992 |
---|---|
author | Stoehlmacher, J Park, D J Zhang, W Yang, D Groshen, S Zahedy, S Lenz, H-J |
author_facet | Stoehlmacher, J Park, D J Zhang, W Yang, D Groshen, S Zahedy, S Lenz, H-J |
author_sort | Stoehlmacher, J |
collection | PubMed |
description | In this marker evaluation study, we tested whether distinct patterns of functional genomic polymorphisms in genes involved in drug metabolic pathways and DNA repair that predict clinical outcome to 5-fluorouracil (5-FU)/oxaliplatin chemotherapy in patients with advanced colorectal cancer could be identified. Functional polymorphisms in DNA-repair genes XPD, ERCC1, XRCC1, XPA, and metabolising genes glutathione S-transferase GSTP1, GSTT1, GSTM1, and thymidylate synthase (TS) were assessed retrospectively in 106 patients with refractory stage IV disease who received 5-FU/oxaliplatin combination chemotherapy, using a polymerase chain reaction-based RFLP technique. Favourable genotypes from polymorphisms in XPD-751, ERCC1-118, GSTP1-105, and TS-3′-untranslated region (3′UTR) that are associated with overall survival were identified. After adjustment for performance status, the relative risks of dying for patients who possessed the unfavourable genotype were: 3.33 for XPD-751 (P=0.037), 3.25 for GSTP1-105 (P=0.072), 2.05 for ERCC1-118 (P=0.037), and 1.65 for TS-3′UTR (P=0.091) when compared to their respective beneficial genomic variants. Combination analysis with all four polymorphisms revealed that patients possessing ⩾2 favourable genotypes survived a median of 17.4 months (95% confidence interval (CI): 9.4, 26.5) compared to 5.4 months (95% CI: 4.3, 6.0) in patients with no favourable genotype. Patients who carried one favourable genotype demonstrated intermediate survival of 10.2 months (95% CI: 6.8, 15.3; P<0.001). Polymorphisms in the TS-3′UTR and GSTP1-105 gene were also associated with time to progression. After adjustment for performance status, patients with an unfavourable TS-3′UTR genotype had a relative risk of disease progression of 1.76 (P=0.020) and those with the unfavourable GSTP1-105 genotype showed a relative risk of progression of 2.00 (P=0.018). The genomic polymorphisms XPD-751, ERCC1-118, GSTP1-105, and TS-3′UTR may be useful in predicting overall survival and time to progression of colorectal cancer in patients who receive 5-FU/oxaliplatin chemotherapy. These findings require independent prospective confirmation. |
format | Text |
id | pubmed-2409815 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2004 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-24098152009-09-10 A multivariate analysis of genomic polymorphisms: prediction of clinical outcome to 5-FU/oxaliplatin combination chemotherapy in refractory colorectal cancer Stoehlmacher, J Park, D J Zhang, W Yang, D Groshen, S Zahedy, S Lenz, H-J Br J Cancer Genetics and Genomics In this marker evaluation study, we tested whether distinct patterns of functional genomic polymorphisms in genes involved in drug metabolic pathways and DNA repair that predict clinical outcome to 5-fluorouracil (5-FU)/oxaliplatin chemotherapy in patients with advanced colorectal cancer could be identified. Functional polymorphisms in DNA-repair genes XPD, ERCC1, XRCC1, XPA, and metabolising genes glutathione S-transferase GSTP1, GSTT1, GSTM1, and thymidylate synthase (TS) were assessed retrospectively in 106 patients with refractory stage IV disease who received 5-FU/oxaliplatin combination chemotherapy, using a polymerase chain reaction-based RFLP technique. Favourable genotypes from polymorphisms in XPD-751, ERCC1-118, GSTP1-105, and TS-3′-untranslated region (3′UTR) that are associated with overall survival were identified. After adjustment for performance status, the relative risks of dying for patients who possessed the unfavourable genotype were: 3.33 for XPD-751 (P=0.037), 3.25 for GSTP1-105 (P=0.072), 2.05 for ERCC1-118 (P=0.037), and 1.65 for TS-3′UTR (P=0.091) when compared to their respective beneficial genomic variants. Combination analysis with all four polymorphisms revealed that patients possessing ⩾2 favourable genotypes survived a median of 17.4 months (95% confidence interval (CI): 9.4, 26.5) compared to 5.4 months (95% CI: 4.3, 6.0) in patients with no favourable genotype. Patients who carried one favourable genotype demonstrated intermediate survival of 10.2 months (95% CI: 6.8, 15.3; P<0.001). Polymorphisms in the TS-3′UTR and GSTP1-105 gene were also associated with time to progression. After adjustment for performance status, patients with an unfavourable TS-3′UTR genotype had a relative risk of disease progression of 1.76 (P=0.020) and those with the unfavourable GSTP1-105 genotype showed a relative risk of progression of 2.00 (P=0.018). The genomic polymorphisms XPD-751, ERCC1-118, GSTP1-105, and TS-3′UTR may be useful in predicting overall survival and time to progression of colorectal cancer in patients who receive 5-FU/oxaliplatin chemotherapy. These findings require independent prospective confirmation. Nature Publishing Group 2004-07-19 2004-06-22 /pmc/articles/PMC2409815/ /pubmed/15213713 http://dx.doi.org/10.1038/sj.bjc.6601975 Text en Copyright © 2004 Cancer Research UK https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Genetics and Genomics Stoehlmacher, J Park, D J Zhang, W Yang, D Groshen, S Zahedy, S Lenz, H-J A multivariate analysis of genomic polymorphisms: prediction of clinical outcome to 5-FU/oxaliplatin combination chemotherapy in refractory colorectal cancer |
title | A multivariate analysis of genomic polymorphisms: prediction of clinical outcome to 5-FU/oxaliplatin combination chemotherapy in refractory colorectal cancer |
title_full | A multivariate analysis of genomic polymorphisms: prediction of clinical outcome to 5-FU/oxaliplatin combination chemotherapy in refractory colorectal cancer |
title_fullStr | A multivariate analysis of genomic polymorphisms: prediction of clinical outcome to 5-FU/oxaliplatin combination chemotherapy in refractory colorectal cancer |
title_full_unstemmed | A multivariate analysis of genomic polymorphisms: prediction of clinical outcome to 5-FU/oxaliplatin combination chemotherapy in refractory colorectal cancer |
title_short | A multivariate analysis of genomic polymorphisms: prediction of clinical outcome to 5-FU/oxaliplatin combination chemotherapy in refractory colorectal cancer |
title_sort | multivariate analysis of genomic polymorphisms: prediction of clinical outcome to 5-fu/oxaliplatin combination chemotherapy in refractory colorectal cancer |
topic | Genetics and Genomics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2409815/ https://www.ncbi.nlm.nih.gov/pubmed/15213713 http://dx.doi.org/10.1038/sj.bjc.6601975 |
work_keys_str_mv | AT stoehlmacherj amultivariateanalysisofgenomicpolymorphismspredictionofclinicaloutcometo5fuoxaliplatincombinationchemotherapyinrefractorycolorectalcancer AT parkdj amultivariateanalysisofgenomicpolymorphismspredictionofclinicaloutcometo5fuoxaliplatincombinationchemotherapyinrefractorycolorectalcancer AT zhangw amultivariateanalysisofgenomicpolymorphismspredictionofclinicaloutcometo5fuoxaliplatincombinationchemotherapyinrefractorycolorectalcancer AT yangd amultivariateanalysisofgenomicpolymorphismspredictionofclinicaloutcometo5fuoxaliplatincombinationchemotherapyinrefractorycolorectalcancer AT groshens amultivariateanalysisofgenomicpolymorphismspredictionofclinicaloutcometo5fuoxaliplatincombinationchemotherapyinrefractorycolorectalcancer AT zahedys amultivariateanalysisofgenomicpolymorphismspredictionofclinicaloutcometo5fuoxaliplatincombinationchemotherapyinrefractorycolorectalcancer AT lenzhj amultivariateanalysisofgenomicpolymorphismspredictionofclinicaloutcometo5fuoxaliplatincombinationchemotherapyinrefractorycolorectalcancer AT stoehlmacherj multivariateanalysisofgenomicpolymorphismspredictionofclinicaloutcometo5fuoxaliplatincombinationchemotherapyinrefractorycolorectalcancer AT parkdj multivariateanalysisofgenomicpolymorphismspredictionofclinicaloutcometo5fuoxaliplatincombinationchemotherapyinrefractorycolorectalcancer AT zhangw multivariateanalysisofgenomicpolymorphismspredictionofclinicaloutcometo5fuoxaliplatincombinationchemotherapyinrefractorycolorectalcancer AT yangd multivariateanalysisofgenomicpolymorphismspredictionofclinicaloutcometo5fuoxaliplatincombinationchemotherapyinrefractorycolorectalcancer AT groshens multivariateanalysisofgenomicpolymorphismspredictionofclinicaloutcometo5fuoxaliplatincombinationchemotherapyinrefractorycolorectalcancer AT zahedys multivariateanalysisofgenomicpolymorphismspredictionofclinicaloutcometo5fuoxaliplatincombinationchemotherapyinrefractorycolorectalcancer AT lenzhj multivariateanalysisofgenomicpolymorphismspredictionofclinicaloutcometo5fuoxaliplatincombinationchemotherapyinrefractorycolorectalcancer |