Association of tumor necrosis factor-α polymorphism with chemotherapy-induced oral mucositis in patients with esophageal cancer

Genetic polymorphisms as predictive biomarkers of adverse events during preoperative chemotherapy in esophageal cancer

PURPOSE

This study aimed to explore associations between genetic polymorphisms and adverse effects due to preoperative chemotherapy with docetaxel, cisplatin, and fluorouracil (DCF) for esophageal cancer.

METHODS

Preoperative DCF (docetaxel, 70 mg/m2/day, day 1; cisplatin, 70 mg/m2/day, day 1; fluorouracil, 750 mg/m2/day, days 1-5) was repeated every 3 weeks for up to three cycles. Genotyping of nine candidate genetic polymorphisms was conducted using blood samples from the enrolled patients.

RESULTS

According to a multivariable analysis evaluating 50 patients, grade 3 or worse neutropenia was more likely to occur in those with the ABCC2-24C/T or T/T genotype (rs717620) (OR, 5.30, P = 0.013). Additionally, patients with the TYMS 3'-UTR 0 bp/0 bp genotype (rs151264360) showed a trend toward grade 3 or worse hyponatremia (OR, 0.16, P = 0.005). Grade 2 or worse thrombocytopenia was more likely to occur in patients with the TNF-α-1031C/T or T/T genotype (rs1799964) (OR, 6.30, P = 0.016) and IL-6-634C/C genotype (rs1800796) (OR, 0.18, P = 0.034), and grade 2 or worse anemia was more likely to occur in patients with the MCP-1-2518G/G genotype (rs1024611) (OR, 0.19, P = 0.027).

CONCLUSIONS

ABCC2-24C > T (rs717620), TYMS 3'-UTR 6-bp indel (rs151264360), TNF-α-1031T > C (rs1799964) as well as IL-6-634G > C (rs1800796), and MCP-1-2518A > G (rs1024611) polymorphisms might serve as independent and predictive biomarkers for neutropenia, hyponatremia, thrombocytopenia, and anemia, respectively, during preoperative chemotherapy with docetaxel, cisplatin, and fluorouracil for patients with esophageal cancer.

Comparison of therapeutic effects of statins and aloe vera mouthwash on chemotherapy induced oral mucositis

BACKGROUND

Chemotherapy induced oral mucositis is a common problem among patients with cancer. Different therapeutic agents have been evaluated to prevent or treat the disease. Here we aimed to compare therapeutic effects of atorvastatin and aloe vera mouthwash on chemotherapy induced oral mucositis.

METHODS

120 patients with large intestine and gastric cancer who were treated with 5-fluorouracil (FOLFOX4) for the first time were entered and randomized into 3 groups. Group 1 received tablets of atorvastatin 10 mg daily until 2 weeks after chemotherapy sessions plus placebo mouthwash. Group 2 received aloe vera mouthwash plus placebo tablets and group 3 received placebo mouthwash and placebo tablets until 2 weeks after chemotherapy sessions. Severity of mucositis was assessed using world health organization (WHO) indexes. Based on this method, mucositis is divided into 4 grades. This study was approved by Iranian Registry of Clinical Trials (IRCT) with the code of: IRCT20201203049585N1 (https://fa.irct.ir/trial/54037).

RESULTS

Analysis of the incidence of mucositis among patients showed that in placebo group, 50% of patients experienced grade 2 to 4 mucositis. In group 1, 9 patients (22.5%) had grade 2 mucositis and 6 patients (15%) had grade 3 mucositis and 4 patients (10%) had grade 4 mucositis. In group 2, only 1 patient (2.5%) was diagnosed with grade 2 mucositis. These data showed no significant differences between group 1 and group 3 (P=0.674), but the therapeutic results of group 2 were significantly better than those of group 3 (P=0.042) and group 1 (P=0.036).

CONCLUSION

We showed that treatments with aloe vera mouthwash could be an effective choice in prevention of mucositis for patients undergoing chemotherapy. There are also much to discover about effects of aloe vera mouthwash on this disease.

Predicting mucositis risk associated with cytotoxic cancer treatment regimens: rationale, complexity, and challenges

PURPOSE OF REVIEW

The goals of this review are to describe the complexity of factors influencing the risk of cancer regimen-related mucosal injury (CRRMI), to evaluate the contribution of the innate immune response to CRRMI risk, to compare the concordance of genome analytics in describing mechanism and risk, and to determine if common biological pathways are noted when CRRMI is compared to a disease with a similar phenotype.

RECENT FINDINGS

The pathogenesis of and risk for CRRMI are complex and influenced by multiple intrinsic and extrinsic factors. It is incumbent on analyses to recognize the likelihood that the interplay and cross-talk of synergistically expressed factors is critical and that the contributing weights of these factors is not uniform from patient to patient. Genomically derived analyses imply final common pathways are implicit in phenotype expression.

SUMMARY

The identification of specific factors (both genomic and otherwise) which contribute to CRRMI risk represents an important opportunity to apply principles of precision medicine to the management of regimen-related toxicities.