Evaluation of clinical and economic impact of pharmacogenomics testing in taxanes-based therapy

WCRJ 2016; 3 (3): e744

  Topic: Pharmacogenomics     Category:

Abstract

Introduction: Taxanes are the most common anticancer drugs used to treat several types of neoplasms, such as lung, colorectal, ovarian, breast, head/neck, and genitourinary cancers. However, the efficacy of taxanes-based therapy is often compromised by the severe risk of adverse effects.

Background: Pharmacogenomic testing is a promising strategy for cancer management and personalized therapy, allowing stratification of patients for drug response and toxicity, in order to make treatment decisions to maximize benefits and minimize toxicity.

Materials and Methods: The search of the MEDLINE, EMBASE and PubMed databases was systematically performed (complete syntax is reported below). Restrictions about the date of publication (1 January 2000 to present day) and language (English) were applied. The references of the resulting issues were also manually considered. Moreover, the cost-effectiveness of the methods used to detect these polymorphisms was taken into account.

Results: Several genes that influence pharmacokinetics and pharmacodynamics of taxanes were investigated: members of cytochrome P450 family (CYP2C8, 3A4 and 3A5), b-tubulin (TUBB), Glutathione S-Transferase (GST) and ATP-binding cassette family (ABC). CYP2C8 *3 and *4, CYP3A4 *22 and *1B, GSTP1 and different SNPs in ABCB1 were found to correlate with increased risk of toxicity. Other allelic variants were studied, but the data are often not replicated, or even in contrast, among different authors. Moreover, defining the allelic status of a patient using PCR-based methods allows to significantly reduce global costs.

Discussion and Conclusions: Pharmacogenomics markers are constantly increasing and being validated, allowing the physicians to personalize treatments based on the individual genetic profile. Although further studies are needed, the development of a genotyping panel test for clinical practice seems to be more and more realistic.

To cite this article

Evaluation of clinical and economic impact of pharmacogenomics testing in taxanes-based therapy

WCRJ 2016; 3 (3): e744

Publication History

Submission date: 07 Sep 2016

Revised on: 16 Sep 2016

Accepted on: 27 Nov 2016

Published online: 03 Oct 2016