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Pathak S, Zajac KK, Annaji M, Govindarajulu M, Nadar RM, Bowen D, Babu RJ, Dhanasekaran M. Clinical outcomes of chemotherapy in cancer patients with different ethnicities. Cancer Rep (Hoboken) 2023; 6 Suppl 1:e1830. [PMID: 37150853 PMCID: PMC10440845 DOI: 10.1002/cnr2.1830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 05/09/2023] Open
Abstract
BACKGROUND Choosing the most effective chemotherapeutic agent with safest side effect profile is a common challenge in cancer treatment. Although there are standardized chemotherapy protocols in place, protocol changes made after extensive clinical trials demonstrate significant improvement in the efficacy and tolerability of certain drugs. The pharmacokinetics, pharmacodynamics, and tolerance of anti-cancer medications are all highly individualized. A driving force behind these differences lies within a person's genetic makeup. RECENT FINDINGS Pharmacogenomics, the study of how an individual's genes impact the processing and action of a drug, can optimize drug responsiveness and reduce toxicities by creating a customized medication regimen. However, these differences are rarely considered in the initial determination of standardized chemotherapeutic protocols and treatment algorithms. Because pharmacoethnicity is influenced by both genetic and nongenetic variables, clinical data highlighting disparities in the frequency of polymorphisms between different ethnicities is steadily growing. Recent data suggests that ethnic variations in the expression of allelic variants may result in different pharmacokinetic properties of the anti-cancer medication. In this article, the clinical outcomes of various chemotherapy classes in patients of different ethnicities were reviewed. CONCLUSION Genetic and nongenetic variables contribute to the interindividual variability in response to chemotherapeutic drugs. Considering pharmacoethnicity in the initial determination of standard chemotherapeutic protocols and treatment algorithms can lead to better clinical outcomes of patients of different ethnicities.
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Affiliation(s)
- Suhrud Pathak
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - Kelsee K. Zajac
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical SciencesUniversity of ToledoToledoOhioUSA
| | - Manjusha Annaji
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - Manoj Govindarajulu
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - Rishi M. Nadar
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - Dylan Bowen
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - R. Jayachandra Babu
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
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2
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Damiani D, Tiribelli M. ABCG2 in Acute Myeloid Leukemia: Old and New Perspectives. Int J Mol Sci 2023; 24:ijms24087147. [PMID: 37108308 PMCID: PMC10138346 DOI: 10.3390/ijms24087147] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Despite recent advances, prognosis of acute myeloid leukemia (AML) remains unsatisfactory due to poor response to therapy or relapse. Among causes of resistance, over-expression of multidrug resistance (MDR) proteins represents a pivotal mechanism. ABCG2 is an efflux transporter responsible for inducing MDR in leukemic cells; through its ability to extrude many antineoplastic drugs, it leads to AML resistance and/or relapse, even if conflicting data have been reported to date. Moreover, ABCG2 may be co-expressed with other MDR-related proteins and is finely regulated by epigenetic mechanisms. Here, we review the main issues regarding ABCG2 activity and regulation in the AML clinical scenario, focusing on its expression and the role of polymorphisms, as well as on the potential ways to inhibit its function to counteract drug resistance to, eventually, improve outcomes in AML patients.
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Affiliation(s)
- Daniela Damiani
- Division of Hematology and Stem Cell Transplantation, Udine Hospital, P.le Santa Maria della Misericordia, 5, 33100 Udine, Italy
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Mario Tiribelli
- Division of Hematology and Stem Cell Transplantation, Udine Hospital, P.le Santa Maria della Misericordia, 5, 33100 Udine, Italy
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
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3
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Megías-Vericat JE, Martínez-Cuadrón D, Solana-Altabella A, Poveda JL, Montesinos P. Systematic Review of Pharmacogenetics of ABC and SLC Transporter Genes in Acute Myeloid Leukemia. Pharmaceutics 2022; 14:pharmaceutics14040878. [PMID: 35456712 PMCID: PMC9030330 DOI: 10.3390/pharmaceutics14040878] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/11/2022] [Accepted: 04/14/2022] [Indexed: 12/20/2022] Open
Abstract
Antineoplastic uptake by blast cells in acute myeloid leukemia (AML) could be influenced by influx and efflux transporters, especially solute carriers (SLCs) and ATP-binding cassette family (ABC) pumps. Genetic variability in SLC and ABC could produce interindividual differences in clinical outcomes. A systematic review was performed to evaluate the influence of SLC and ABC polymorphisms and their combinations on efficacy and safety in AML cohorts. Anthracycline intake was especially influenced by SLCO1B1 polymorphisms, associated with lower hepatic uptake, showing higher survival rates and toxicity in AML studies. The variant alleles of ABCB1 were related to anthracycline intracellular accumulation, increasing complete remission, survival and toxicity. Similar findings have been suggested with ABCC1 and ABCG2 polymorphisms. Polymorphisms of SLC29A1, responsible for cytarabine uptake, demonstrated significant associations with survival and response in Asian populations. Promising results were observed with SLC and ABC combinations regarding anthracycline toxicities. Knowledge of the role of transporter pharmacogenetics could explain the differences observed in drug disposition in the blast. Further studies including novel targeted therapies should be performed to determine the influence of genetic variability to individualize chemotherapy schemes.
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Affiliation(s)
- Juan Eduardo Megías-Vericat
- Servicio de Farmacia, Área del Medicamento, Hospital Universitario y Politécnico La Fe, Avda. Fernando Abril Martorell 106, 46026 Valencia, Spain; (J.E.M.-V.); (A.S.-A.); (J.L.P.)
| | - David Martínez-Cuadrón
- Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Avda. Fernando Abril Martorell 106, 46026 Valencia, Spain;
| | - Antonio Solana-Altabella
- Servicio de Farmacia, Área del Medicamento, Hospital Universitario y Politécnico La Fe, Avda. Fernando Abril Martorell 106, 46026 Valencia, Spain; (J.E.M.-V.); (A.S.-A.); (J.L.P.)
- Instituto de Investigación Sanitaria La Fe, Avda. Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - José Luis Poveda
- Servicio de Farmacia, Área del Medicamento, Hospital Universitario y Politécnico La Fe, Avda. Fernando Abril Martorell 106, 46026 Valencia, Spain; (J.E.M.-V.); (A.S.-A.); (J.L.P.)
| | - Pau Montesinos
- Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Avda. Fernando Abril Martorell 106, 46026 Valencia, Spain;
- Correspondence: ; Tel.: +34-961-245876
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4
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Vasconcelos FC, de Souza PS, Hancio T, de Faria FCC, Maia RC. Update on drug transporter proteins in acute myeloid leukemia: Pathological implication and clinical setting. Crit Rev Oncol Hematol 2021; 160:103281. [PMID: 33667660 DOI: 10.1016/j.critrevonc.2021.103281] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 12/11/2020] [Accepted: 02/27/2021] [Indexed: 12/17/2022] Open
Abstract
Acute myeloid leukemia (AML) is one of the most common hematological neoplasia causing death worldwide. The long-term overall survival is unsatisfactory due to many factors including older age, genetic heterogeneity and molecular characteristics comprising additional mutations, and resistance to chemotherapeutic drugs. The expression of ABCB1/P-glycoprotein, ABCC1/MRP1, ABCG2/BCRP and LRP transporter proteins is considered the major reason for multidrug resistance (MDR) in AML, however conflicting data have been reported. Here, we review the main issues about drug transporter proteins in AML clinical scenario, and highlight the clinicopathological significance of MDR phenotype associated with ABCB1 polymorphisms and FLT3 mutation.
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Affiliation(s)
- Flavia Cunha Vasconcelos
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil
| | - Paloma Silva de Souza
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil; Laboratório de Produtos Bioativos, Polo Novo Cavaleiros/IMCT, Campus Professor Aloisio Teixeira (UFRJ/Macaé), Universidade Federal do Rio de Janeiro (UFRJ), Macaé, RJ, Brazil
| | - Thaís Hancio
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil; Programa de Pós-Graduação Stricto Sensu em Oncologia, INCA, RJ, Brazil
| | - Fernanda Costas Casal de Faria
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil
| | - Raquel Ciuvalschi Maia
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil.
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5
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Megías-Vericat JE, Martínez-Cuadrón D, Herrero MJ, Rodríguez-Veiga R, Solana-Altabella A, Boluda B, Ballesta-López O, Cano I, Acuña-Cruz E, Cervera J, Poveda JL, Sanz M, Aliño SF, Montesinos P. Impact of combinations of single-nucleotide polymorphisms of anthracycline transporter genes upon the efficacy and toxicity of induction chemotherapy in acute myeloid leukemia. Leuk Lymphoma 2020; 62:659-668. [PMID: 33135528 DOI: 10.1080/10428194.2020.1839650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Anthracycline uptake could be affected by influx and efflux transporters in acute myeloid leukemia (AML). Combinations of single-nucleotide polymorphisms (SNPs) of wild-type genotype of influx transporters (SLC22A16, SLCO1B1) and homozygous variant genotypes of ABC polymorphisms (ABCB1, ABCC1, ABCC2, ABCG2) were evaluated in 225 adult de novo AML patients. No differences in complete remission were reported, but higher induction death was observed with combinations of SLCO1B1 rs4149056 and ABCB1 (triple variant haplotype, rs1128503), previously associated with ABCB1 and SLCO1B1 SNPs. Several combinations of SLCO1B1 and SLC22A16 with ABCB1 SNPs were associated with higher toxicities, including nephrotoxicity and hepatotoxicity, neutropenia, previously related to ABCB1, and a novel correlation with mucositis. Combination of SLC22A16 rs714368 and ABCG2 rs2231142 was related to cardiac toxicity, reproducing previous correlations with ABCG2. This study shows the impact of transporter polymorphisms in AML chemotherapy safety. Further prospective studies with larger populations are needed to validate these associations.
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Affiliation(s)
- Juan Eduardo Megías-Vericat
- Grupo de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento, Hospital Universitari i Politècnic, Valencia, Spain.,Servicio de Farmacia, Área del Medicamento. Hospital Universitari i Politècnic, Valencia, Spain
| | - David Martínez-Cuadrón
- Servicio de Hematología y Hemoterapia. Hospital Universitari i Politècnic, Valencia, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - María José Herrero
- Grupo de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento, Hospital Universitari i Politècnic, Valencia, Spain.,Departamento Farmacología, Facultad de Medicina, Universidad de Valencia, Valencia, Spain
| | - Rebeca Rodríguez-Veiga
- Servicio de Hematología y Hemoterapia. Hospital Universitari i Politècnic, Valencia, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
| | | | - Blanca Boluda
- Servicio de Hematología y Hemoterapia. Hospital Universitari i Politècnic, Valencia, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Octavio Ballesta-López
- Servicio de Farmacia, Área del Medicamento. Hospital Universitari i Politècnic, Valencia, Spain
| | - Isabel Cano
- Servicio de Hematología y Hemoterapia. Hospital Universitari i Politècnic, Valencia, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Evelyn Acuña-Cruz
- Servicio de Hematología y Hemoterapia. Hospital Universitari i Politècnic, Valencia, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - José Cervera
- Servicio de Hematología y Hemoterapia. Hospital Universitari i Politècnic, Valencia, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - José Luis Poveda
- Servicio de Farmacia, Área del Medicamento. Hospital Universitari i Politècnic, Valencia, Spain
| | - MiguelÁngel Sanz
- Servicio de Hematología y Hemoterapia. Hospital Universitari i Politècnic, Valencia, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Salvador F Aliño
- Grupo de Farmacogenética, Instituto Investigación Sanitaria La Fe and Área del Medicamento, Hospital Universitari i Politècnic, Valencia, Spain.,Departamento Farmacología, Facultad de Medicina, Universidad de Valencia, Valencia, Spain.,Unidad de Farmacología Clínica, Área del Medicamento. Hospital Universitari I Politècnic, Valencia, Spain
| | - Pau Montesinos
- Servicio de Hematología y Hemoterapia. Hospital Universitari i Politècnic, Valencia, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
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6
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Abstract
The transport of specific molecules across lipid membranes is an essential function of all living organisms. The processes are usually mediated by specific transporters. One of the largest transporter families is the ATP-binding cassette (ABC) family. More than 40 ABC transporters have been identified in human, which are divided into 7 subfamilies (ABCA to ABCG) based on their gene structure, amino acid sequence, domain organization, and phylogenetic analysis. Of them, at least 11 ABC transporters including P-glycoprotein (P-GP/ABCB1), multidrug resistance-associated proteins (MRPs/ABCCs), and breast cancer resistance protein (BCRP/ABCG2) are involved in multidrug resistance (MDR) development. These ABC transporters are expressed in various tissues such as the liver, intestine, kidney, and brain, playing important roles in absorption, distribution, and excretion of drugs. Some ABC transporters are also involved in diverse cellular processes such as maintenance of osmotic homeostasis, antigen processing, cell division, immunity, cholesterol, and lipid trafficking. Several human diseases such as cystic fibrosis, sitosterolemia, Tangier disease, intrahepatic cholestasis, and retinal degeneration are associated with mutations in corresponding transporters. This chapter will describe function and expression of several ABC transporters (such as P-GP, BCRP, and MRPs), their substrates and inhibitors, as well as their clinical significance.
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Affiliation(s)
- Xiaodong Liu
- China Pharmaceutical University, Nanjing, China.
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7
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Heyes N, Kapoor P, Kerr ID. Polymorphisms of the Multidrug Pump ABCG2: A Systematic Review of Their Effect on Protein Expression, Function, and Drug Pharmacokinetics. Drug Metab Dispos 2018; 46:1886-1899. [PMID: 30266733 DOI: 10.1124/dmd.118.083030] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/20/2018] [Indexed: 12/11/2022] Open
Abstract
The widespread expression and polyspecificity of the multidrug ABCG2 efflux transporter make it an important determinant of the pharmacokinetics of a variety of substrate drugs. Null ABCG2 expression has been linked to the Junior blood group. Polymorphisms affecting the expression or function of ABCG2 may have clinically important roles in drug disposition and efficacy. The most well-studied single nucleotide polymorphism (SNP), Q141K (421C>A), is shown to decrease ABCG2 expression and activity, resulting in increased total drug exposure and decreased resistance to various substrates. The effect of Q141K can be rationalized by inspection of the ABCG2 structure, and the effects of this SNP on protein processing may make it a target for pharmacological intervention. The V12M SNP (34G>A) appears to improve outcomes in cancer patients treated with tyrosine kinase inhibitors, but the reasons for this are yet to be established, and this residue's role in the mechanism of the protein is unexplored by current biochemical and structural approaches. Research into the less-common polymorphisms is confined to in vitro studies, with several polymorphisms shown to decrease resistance to anticancer agents such as SN-38 and mitoxantrone. In this review, we present a systematic analysis of the effects of ABCG2 polymorphisms on ABCG2 function and drug pharmacokinetics. Where possible, we use recent structural advances to present a molecular interpretation of the effects of SNPs and indicate where we need further in vitro experiments to fully resolve how SNPs impact ABCG2 function.
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Affiliation(s)
- Niall Heyes
- School of Life Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Parth Kapoor
- School of Life Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Ian D Kerr
- School of Life Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom
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8
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9
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Varatharajan S, Abraham A, Karathedath S, Ganesan S, Lakshmi KM, Arthur N, Srivastava VM, George B, Srivastava A, Mathews V, Balasubramanian P. ATP-binding casette transporter expression in acute myeloid leukemia: association with in vitro cytotoxicity and prognostic markers. Pharmacogenomics 2017; 18:235-244. [PMID: 28112576 DOI: 10.2217/pgs-2016-0150] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Drug resistance and relapse are considered to be the major reasons for treatment failure in acute myeloid leukemia (AML). There is limited data on the role of ABC transporter expression on in vitro sensitivity to cytarabine (Ara-C) and daunorubicin (Dnr) in primary AML cells. PATIENTS & METHODS RNA expression levels of 12 ABC transporters were analyzed by real-time quantitative PCR in 233 de novo adult acute myeloid leukemia patients. Based on cytarabine or Dnr IC50, the samples were categorized as sensitive, intermediate and resistant. Role of candidate ABC transporter RNA expression on in vitro cytotoxicity, treatment outcome post therapy as well as the influence of various prognostic markers on ABC transporter expression were analyzed. RESULTS Expression of ABCC3 and ABCB6 were significantly higher in Dnr-resistant samples when compared with Dnr-sensitive samples. Increased ABCC1 expression was associated with poor disease-free survival in this cohort of patients. CONCLUSION This comprehensive analysis suggests ABCC1, ABCC3, ABCB6 and ABCA5 as probable targets which can be modulated for improving chemotherapeutic responses.
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Affiliation(s)
| | - Ajay Abraham
- Department of Haematology, Christian Medical College, Vellore, India
| | | | - Sukanya Ganesan
- Department of Haematology, Christian Medical College, Vellore, India
| | - Kavitha M Lakshmi
- Department of Haematology, Christian Medical College, Vellore, India
| | - Nancy Arthur
- Department of Haematology, Christian Medical College, Vellore, India
| | | | - Biju George
- Department of Haematology, Christian Medical College, Vellore, India
| | - Alok Srivastava
- Department of Haematology, Christian Medical College, Vellore, India
| | - Vikram Mathews
- Department of Haematology, Christian Medical College, Vellore, India
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10
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Megías-Vericat JE, Montesinos P, Herrero MJ, Moscardó F, Bosó V, Rojas L, Martínez-Cuadrón D, Hervás D, Boluda B, García-Robles A, Rodríguez-Veiga R, Martín-Cerezuela M, Cervera J, Sendra L, Sanz J, Miguel A, Lorenzo I, Poveda JL, Sanz MÁ, Aliño SF. Impact of ABC single nucleotide polymorphisms upon the efficacy and toxicity of induction chemotherapy in acute myeloid leukemia. Leuk Lymphoma 2016; 58:1197-1206. [PMID: 27701910 DOI: 10.1080/10428194.2016.1231405] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Anthracycline uptake could be affected by efflux pumps of the ABC family. The influence of 7 SNPs of ABC genes was evaluated in 225 adult de novo acute myeloid leukemia (AML) patients. After multivariate logistic regression there were no significant differences in complete remission, though induction death was associated to ABCB1 triple variant haplotype (p = .020). The ABCB1 triple variant haplotype was related to higher nephrotoxicity (p = .016), as well as this haplotype and the variant allele of ABCB1 rs1128503, rs2032582 to hepatotoxicity (p = .001; p = .049; p < .001). Furthermore, the variant allele of ABCC1 rs4148350 was related to severe hepatotoxicity (p = .044), and the variant allele of ABCG2 rs2231142 was associated to greater cardiac (p = .004) and lung toxicities (p = .038). Delayed time to neutropenia recovery was observed with ABCB1 rs2032582 variant (p = .047). This study shows the impact of ABC polymorphisms in AML chemotherapy safety. Further prospective studies with larger population are needed to validate these associations.
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Affiliation(s)
- Juan Eduardo Megías-Vericat
- a Unidad de Farmacogenética, Instituto Investigación Sanataria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain.,b Servicio de Farmacia, Área del Medicamento. Hospital Universitario y Politécnico La Fe Avda , Valencia , Spain
| | - Pau Montesinos
- c Servicio de Hematología y Hemoterapia. Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain
| | - María José Herrero
- a Unidad de Farmacogenética, Instituto Investigación Sanataria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain.,d Departamento Farmacología, Facultad de Medicina , Universidad de Valencia. Avda , Valencia , Spain
| | - Federico Moscardó
- c Servicio de Hematología y Hemoterapia. Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain
| | - Virginia Bosó
- a Unidad de Farmacogenética, Instituto Investigación Sanataria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain.,b Servicio de Farmacia, Área del Medicamento. Hospital Universitario y Politécnico La Fe Avda , Valencia , Spain
| | - Luis Rojas
- a Unidad de Farmacogenética, Instituto Investigación Sanataria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain.,e Department of Internal Medicine, Faculty of Medicine , Pontificia Universidad Católica de Chile. Avda , Santiago , Chile
| | - David Martínez-Cuadrón
- c Servicio de Hematología y Hemoterapia. Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain
| | - David Hervás
- f Unidad de Bioestadística, Instituto investigación Sanataria La Fe. Avda , Valencia , Spain
| | - Blanca Boluda
- c Servicio de Hematología y Hemoterapia. Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain
| | - Ana García-Robles
- b Servicio de Farmacia, Área del Medicamento. Hospital Universitario y Politécnico La Fe Avda , Valencia , Spain
| | - Rebeca Rodríguez-Veiga
- c Servicio de Hematología y Hemoterapia. Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain
| | - María Martín-Cerezuela
- b Servicio de Farmacia, Área del Medicamento. Hospital Universitario y Politécnico La Fe Avda , Valencia , Spain
| | - José Cervera
- c Servicio de Hematología y Hemoterapia. Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain
| | - Luis Sendra
- d Departamento Farmacología, Facultad de Medicina , Universidad de Valencia. Avda , Valencia , Spain
| | - Jaime Sanz
- c Servicio de Hematología y Hemoterapia. Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain
| | - Antonio Miguel
- d Departamento Farmacología, Facultad de Medicina , Universidad de Valencia. Avda , Valencia , Spain
| | - Ignacio Lorenzo
- c Servicio de Hematología y Hemoterapia. Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain
| | - José Luis Poveda
- b Servicio de Farmacia, Área del Medicamento. Hospital Universitario y Politécnico La Fe Avda , Valencia , Spain
| | - Miguel Ángel Sanz
- c Servicio de Hematología y Hemoterapia. Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain
| | - Salvador F Aliño
- a Unidad de Farmacogenética, Instituto Investigación Sanataria La Fe and Área del Medicamento, Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain.,d Departamento Farmacología, Facultad de Medicina , Universidad de Valencia. Avda , Valencia , Spain.,g Unidad de Farmacología Clínica, Área del Medicamento, Hospital Universitario y Politécnico La Fe. Avda , Valencia , Spain
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11
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Natarajan K, Baer MR, Ross DD. Role of Breast Cancer Resistance Protein (BCRP, ABCG2) in Cancer Outcomes and Drug Resistance. RESISTANCE TO TARGETED ANTI-CANCER THERAPEUTICS 2015. [DOI: 10.1007/978-3-319-09801-2_3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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12
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Structure and function of BCRP, a broad specificity transporter of xenobiotics and endobiotics. Arch Toxicol 2014; 88:1205-48. [DOI: 10.1007/s00204-014-1224-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 03/06/2014] [Indexed: 12/20/2022]
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13
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Marin JJG, Monte MJ, Blazquez AG, Macias RIR, Serrano MA, Briz O. The role of reduced intracellular concentrations of active drugs in the lack of response to anticancer chemotherapy. Acta Pharmacol Sin 2014; 35:1-10. [PMID: 24317012 PMCID: PMC3880477 DOI: 10.1038/aps.2013.131] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 08/23/2013] [Indexed: 12/16/2022] Open
Abstract
A major difficulty in the treatment of cancers is the poor response of many tumors to pharmacological regimens. This situation can be accounted for by the existence of a variety of complex mechanisms of chemoresistance (MOCs), leading to reduced intracellular concentrations of active agents, changes in the molecular targets of the drugs, enhanced repair of drug-induced modifications in macromolecules, stimulation of anti-apoptotic mechanisms, and inhibition of pro-apoptotic mechanisms. The present review focuses on alterations in the expression and appearance of the genetic variants that affect the genes involved in reducing the amount of active agents inside tumor cells. These alterations can occur through two mechanisms: either by lowering uptake or enhancing efflux (so-called MOC-1a and MOC-1b, respectively), or by decreasing the activation of prodrugs or enhancing inactivation of active agents through their biotransformation (MOC-2). The development of chemosensitizers that are useful in implementing the pharmacological manipulation of these processes constitutes a challenge to modern pharmacology. Nevertheless, the important physiological roles of the most relevant genes involved in MOC-1a, MOC-1b, and MOC-2 make it difficult to prevent the side effects of chemosensitizers. A more attainable goal in this area of pharmacological enquiry is the identification of proteomic profiles that will permit oncologists to accurately predict a lack of response to a given regimen, which would be useful for adapting treatment to the personal situation of each patient.
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