• DOI:10.1200/JCO.2008.21.7679
• Corpus ID: 2516313

Pharmacogenetic pathway analysis for determination of sunitinib-induced toxicity.

@article{vanErp2009PharmacogeneticPA,
  title={Pharmacogenetic pathway analysis for determination of sunitinib-induced toxicity.},
  author={Nielka P. van Erp and Karel Eechoute and Astrid A M van der Veldt and John B.A.G. Haanen and An K. L. Reyners and Ron H. J. Mathijssen and Epie Boven and Tahar van der Straaten and Ren{\'e}e F. Baak-Pablo and Judith A. M. Wessels and H. J. Guchelaar and Hans J Gelderblom},
  journal={Journal of clinical oncology : official journal of the American Society of Clinical Oncology},
  year={2009},
  volume={27 26},
  pages={
          4406-12
        }
}

• N. V. van Erp, K. Eechoute, +9 authors H. Gelderblom
• Published 10 September 2009
• Biology, Medicine
• Journal of clinical oncology : official journal of the American Society of Clinical Oncology

PURPOSE
To identify genetic markers in the pharmacokinetic and pharmacodynamic pathways of sunitinib that predispose for development of toxicities: thrombocytopenia, leukopenia, mucosal inflammation, hand-foot syndrome, and any toxicity according to National Cancer Institute Common Toxicity Criteria higher than grade 2.

PATIENTS AND METHODS
A multicenter pharmacogenetic association study was performed in 219 patients treated with single-agent sunitinib. A total of 31 single nucleotide polymorphisms in 12 candidate genes, together with several nongenetic variants, were analyzed for a possible association with toxicity. In addition, genetic haplotypes were developed and related to toxicity.

RESULTS
The risk for leukopenia was increased when the G allele in CYP1A1 2455A/G (odds ratio [OR], 6.24; P = .029) or the T allele in FLT3 738T/C (OR, 2.8; P = .008) were present or CAG in the NR1I3 (5719C/T, 7738A/C, 7837T/G) haplotype (OR, 1.74; P = .041) was absent. Any toxicity higher than grade 2 prevalence was increased when the T allele of vascular endothelial growth factor receptor 2 1191C/T (OR, 2.39; P = .046) or a copy of TT in the ABCG2 (-15622C/T, 1143C/T) haplotype (OR, 2.63; P = .016) were present. The risk for mucosal inflammation was increased in the presence of the G allele in CYP1A1 2455A/G (OR, 4.03; P = .021) and the prevalence of hand-foot syndrome was increased when a copy of TTT in the ABCB1 (3435C/T, 1236C/T, 2677G/T) haplotype (OR, 2.56; P = .035) was present.

CONCLUSION
This exploratory study suggests that polymorphisms in specific genes encoding for metabolizing enzymes, efflux transporters, and drug targets are associated with sunitinib-related toxicities. A better understanding of genetic and nongenetic determinants of sunitinib toxicity should help to optimize drug treatment in individual patients.