Association of NQO1Pro187Ser polymorphism with clinical outcomes and survival of lung cancer patients treated with platinum chemotherapy

Structural, functional analysis and association of MSH6 rs1800932, rs1042821 polymorphisms with clinical outcome in North Indian lung cancer patients treated with platinum-based doublet chemotherapy

BACKGROUND

In this study, we have done structural and functional analysis of rs1800932 rs1042821 polymorphisms and tried to estimate any association of these polymorphisms with clinical outcomes in north Indian lung cancer patients.

METHODS

Genotyping of 500 lung cancer patients was completed utilizing PCR-RFLP (Polymerase chain reaction- Restriction fragment length polymorphism). MedCalc statistical software was used to calculate adjusted and unadjusted odds ratios. Various computational tools like SIFT PROVEAN are used for functional analysis. Structural analysis was completed via MODELLER and CHIMERA.

RESULTS

In our study, patients suffering from small cell lung cancer (SCLC) and harboring heterozygous genotype (AG) for MSH6 (rs1800932) polymorphism have reported a significant increase in median survival time (MST) (20.6 vs. 7.6 months, p = 0.03). Furthermore, for MSH6 rs1042821 polymorphism, patients undergoing docetaxel and carbo/cisplatin combination chemotherapeutic regimen and carrying heterogeneous genotype (CT) reported a significant increase in MST (16.6 vs.8.36 months, p = 0.03) and a corresponding decrease in hazard ratio 0.42 (95% CI= 0.18-1.03). Structural and Functional analysis of rs1042821 polymorphism revealed that it is present in the non-coding region of MSH6 protein and is significantly associated with increased overall survival.

CONCLUSIONS

These results suggest that MSH6 rs1800932 rs1042821 polymorphisms are involved in increasing the overall survival of lung cancer patients, further confirmed by computational analysis.

Predictive role of polymorphic variants of phase II drug metabolising enzyme in modulating toxicity in North Indian lung cancer patients undergoing chemotherapy

Genetic polymorphism of drug-metabolizing enzymes such as NQO1, SULT1A1, EPHX1, and NAT2 alters its activity which hampers the detoxification and disposal of chemotherapeutic compounds. Thus, in the present study, we have comprehensively investigated the associations between SNPs of the Phase II detoxifying genes and its relationship towards platinum-induced toxicity of lung cancer patients.A total of 273 samples were enrolled in this study and polymorphisms of gene NQO1 (609C > T), SULT1A1 (Arg²¹³ His), EPHX1 (Tyr¹¹³His, His¹³⁹Arg), and NAT2 (481C > T, 803A > G, 590 G > A, 857 G > A) were evaluated in our study for their associated adverse events caused due to the administration of platinum-based chemotherapy to the lung cancer patients.For NQO1 609C > T polymorphism, the TT genotype showed reduced risk of constipation (OR =0.10, p=0.04) and anorexia (OR =0.15, p=0.03). For SULT1A1 Arg²¹³His, heterozygous genotype (Arg/His) (AOR =0.38, p=0.006) and combined genotype (Arg/His + His/His) were not associated with increased risk of nephrotoxicity (AOR =0.38, p= 0.004). For NAT2, heterozygous (NAT2*4/*6) and combined genotypes (NAT2*4/*4 + *4/*6) for NAT2*6 polymorphism exhibit 2.4 folds (p=0.005), and two-folds (p=0.01) increased risk of hematological toxicity. The heterozygous (AOR =0.45, p=0.004) and variant genotype (AOR =0.39, p=0.02) for NAT2*5C had decreased risk for hematological toxicity. The heterozygous genotype for NAT2*7 polymorphism showed two-fold increased risk for developing thrombocytopenia.This study provides association of NAT2 polymorphic variants in predicting haematological toxicity.