Role of MDM2 T309G Polymorphism in Susceptibility and Prognosis of Nonsmall Cell Lung Cancer: A Meta-Analysis

Association of MDM2 gene SNP 309 polymorphism and human non-small cell lung cancer susceptibility: A meta-analysis

This updated meta-analysis was performed to evaluate the relationship of a common polymorphism (T309 G, rs2279744 T > G) in the murine double minute 2 (MDM2) gene with susceptibility and prognosis of non-small cell lung cancer (NSCLC). The Cochrane Library, PubMed, Embase, CNKI, WanFang and CNKI databases were searched comprehensively for related study. Odds ratios (ORs) with their 95% confidence intervals (95% CI) were calculated. 11 articles with a total 6470 NSCLC patients and 8027 controls met the inclusion criteria were included. MDM2 T309 G polymorphism might be strongly correlated with an increased risk of NSCLC. The overall pooled analysis indicated that MDM2 309 T/G polymorphism was significantly associated with NSCLC susceptibility in the whole population under allelic (OR: 1.22, 95% CI: 1.08-1.38), recessive (OR: 1.37, 95% CI: 1.15-1.63), dominant (OR: 1.23, 95% CI: 1.04-1.45), and homozygous genetic models (OR: 1.49, 95% CI: 1.20-1.86). The subgroup analysis showed a significant association of MDM2 309 T/G polymorphism with NSCLC susceptibility in Asian population, but not in Caucasian population. Besides, a significant association was found again in the female population. The meta-analysis provides convincing evidence that the MDM2 T309 G polymorphism may contribute to NSCLC susceptibility, especially for Asians and women.

Association of the MDM2 SNP285 and SNP309 Genetic Variants with the Risk, Age at Onset and Prognosis of Breast Cancer in Central European Women: A Hospital-Based Case-Control Study

SNP309T>G (rs2279744) and SNP285G>C (rs117039649) in the MDM2 promoter are thought to have opposite effects on the binding of transcription factor SP1 (specificity protein 1), and consequently on MDM2 expression, p53 levels, cancer risk, age at onset, and prognosis. Here, we genotyped SNP309 and SNP285 in 406 Austrian breast cancer patients and 254 female controls. The SNP309GG genotype was associated with an increased breast cancer risk in p53 negative (OR, 1.82; 95% CI, 1.09–3.03; p = 0.02), but not p53 positive or unselected patients. In contrast, the SNP309TT genotype was associated with an earlier age at onset (TT, 57.0 ± 12.9; TG, 58.6 ± 13.9; GG, 59.7 ± 15.0 years; p = 0.048). 31% of SNP309TT, 26% of TG, and 13% of GG tumors were p53 positive (p = 0.034), indicating a lower selective pressure to mutate TP53 in the presence of the G-allele. Moreover, SNP309TT patients exhibited a shortened metastasis-free survival in multivariable analysis. Censoring carriers of the SNP285C-allele hardly altered the strength of these associations of SNP309, thus challenging the proposed antagonistic function of SNP285C towards SNP309G. The minor SNP285C-allele tended to be non-significantly associated with an increased breast cancer risk and a poor disease-free and metastasis-free survival, which may be bystander effects of its complete linkage disequilibrium with SNP309G. We conclude that the SNP309G-allele attenuates the p53-response and leads to a higher breast cancer risk, but also to a later onset of breast cancer and a trend towards a good prognosis.

TP53 and MDM2 genetic alterations in non-small cell lung cancer: Evaluating their prognostic and predictive value

The p53 pathway has been extensively studied for its role in carcinogenesis. Disruption of the pathway occurs in more than half of all cancers, often leading to a worse prognosis for the patient. In recent years several compounds have been successfully developed to target and restore the p53 pathway, either by blocking the MDM2-p53 interaction, restoring wild type conformation of mutant p53, or exploiting the presence of mutant p53 by blocking DNA damage repair pathways. In this review the known data on the role of p53 on prognosis and response to commonly used chemotherapeutics in non-small cell lung cancer is summarized. The focus is on the presence of genetic alterations in the TP53 or MDM2 gene, p53's main negative regulator. In addition, promising therapeutic options will be discussed in relation to specific alterations in the p53 pathway.