Pharmacogenetic assessment of cytostatic therapy efficacy depending on the polymorphism of T1 and M1 glutathione-S-transferase genes in breast cancer patients
https://doi.org/10.34215/1609-1175-2024-3-53-57
Abstract
Aim. To study the effect of deletion polymorphism of the GST genes (GSTT1, GSTM1) on chemotherapy (CT) efficacy in women diagnosed with breast cancer (BC) in the Primorsky Krai.
Materials and methods. The study involved 132 women with breast cancer aged 23 to 79 years (mean age 48 ± 13 years) who received chemotherapy treatment. The detection of deletion (null) genotypes of GSTM1 and GSTT1 was carried out using multiplex PCR followed by an analysis of the melting curves of the reaction products.
Results. Relapse-free survival (RFS) of BC patients with the “null” GSTT1 genotype was statistically significantly higher (116.7 months (9.6 years) versus 75.8 months (6.2 years)) than in patients with the “normal” GSTT genotype. Thus, in the case of the GSTT1“null” genotype, the risk of disease relapse decreased by 2.4 times (HR = 0.418, CI = 0.191–0.915, p = 0.024). Similar to GSTT1, the DFS of patients with the GSTM1 null genotype increased from 72.7 months (6 years) to 76.1 months (6.3 years). At the same time, the risk of disease relapse in carriers of the “null” GSTM1 genotype decreased by 1.7 times (HR = 0.596, CI = 0.369–0.964, p = 0.033) compared with that in carriers of the “normal” GSTM1 genotype.
Conclusions. Deletion polymorphism of the GSTT1 and GSTM1 genes has a significant impact on chemotherapy efficacy in breast cancer patients. Carriers of “null” genotypes demonstrated a higher RFS and a lower risk of developing disease relapse. Further research in this direction and validation of the data obtained may contribute to individualizing the treatment of breast cancer patients, optimizing chemotherapy regimens, and reducing the number of adverse events.
About the Authors
I. S. GulianRussian Federation
Isabella S. Gulian, assistant at the Institute of Surgery; oncologist
2 Ostryakova Ave., Vladivostok, 690002, Russia
FEFU building 6.2, village Ayaks, I. Russkiy, Vladivostok, 690922, Russia
tel. +7 (964) 41-59-97
E. P. Bystritskaya
Russian Federation
Vladivostok
N. Y. Otstavnykh
Russian Federation
Vladivostok
G. S. Gulyan
Russian Federation
Vladivostok
E. V. Hudchenko
Russian Federation
Vladivostok
E. V. Eliseeva
Russian Federation
Vladivostok
M. P. Isaeva
Russian Federation
Vladivostok
References
1. Sychev DA, Moshetova LK. Problems of integrating medical science, image and practical health care: focus on personalized medicine. Pharmacogenetics and Pharmacogenomics. 2020;(1):3–10 (In Russ.) doi: 10.37489/2588-0527-2020-1-3-10
2. Burdennyy AM, Lukina SS, Zavarykina TM, Pronina IV, Brenner PK, Kapralova MA, Atkarskaya MV, Filippova EA, Ivanova NA, Kruglova MP, Belova MV, Bahrushina EO, Braga EA, Loginov VI. Pharmacogenetics of drugs in breast cancer and new approaches for improvement of their bioavailability. Patologicheskaya Fiziologiya i Eksperimental`naya Terapiya = Pathological Physiology and Experimental Therapy. 2019;64(4):137–50 (In Russ.) doi: 10.25557/0031-2991.2019.04.137-150
3. Abramov ME, Shvarova AV, Stepanova EV. Towards individualized treatment: predictive factors for chemotherapy related toxic effect. Bone and Soft Tissue Sarcomas, Tumors of the Skin. 2011;(4):73–6 (In Russ.)
4. Xiang Z, Snouwaert JN, Kovarova M, Nguyen M, Repenning PW, Latour AM, Cyphert JM, Koller BH. Mice lacking three Loci encoding 14 glutathione transferase genes: a novel tool for assigning function to the GSTP, GSTM, and GSTT families. Drug Metab Dispos. 2014;42(6):1074–83. doi: 10.1124/dmd.113.056481
5. Helsby NA, Yong M, van Kan M, de Zoysa JR, Burns KE. The importance of both CYP2C19 and CYP2B6 germline variations in cyclophosphamide pharmacokinetics and clinical outcomes. Br J Clin Pharmacol. 2019;85(9):1925–34. doi: 10.1111/bcp.14031
6. Dirven HA, van Ommen B, van Bladeren PJ. Involvement of human glutathione S-transferase isoenzymes in the conjugation of cyclophosphamide metabolites with glutathione. Cancer Res. 1994;54(23):6215–20.
7. Li S, Lang GT, Zhang YZ, Yu KD, Shao ZM, Zhang Q. Interaction between glutathione S-transferase M1-null/present polymorphism and adjuvant chemotherapy influences the survival of breast cancer. Cancer Med. 2018;7(9):4202–7. doi: 10.1002/cam4.1567
8. Petros, WP, Hopkins PJ, Spruill S, Broadwater G, Vredenburgh JJ, Colvin OM, Peters WP, Jones RB, Hall J & Marks JR. Associations between drug metabolism genotype, chemotherapy pharmacokinetics, and overall survival in patients with breast cancer. J Clin Oncol. 2005; 23(25): 6117–25. doi: 10.1200/JCO.2005.06.075
9. Duggan C, Ballard-Barbash R, Baumgartner RN, Baumgartner KB, Bernstein L, McTiernan A. Associations between null mutations in GSTT1 and GSTM1, the GSTP1 Ile(105)Val polymorphism, and mortality in breast cancer survivors. SpringerPlus. 2013;2: 450. doi: 10.1186/2193-1801-2-450
10. Gulyan IS, Bystritskaya EP, Chernysheva NYu, Eliseeva EV, Apanasevich VI, Isaeva MP. Deletion polymorphism of glutathione S-transferases genes (GSTT1, GSTM1) in patients with breast cancer in Primorye region. Tumors of Female Reproductive System. 2020;16:25–31 (In Russ.) doi: 10.17650/1994-4098-2020-16-3-25-31
11. Tikhomirova AV. Criteria for evaluation of clinical efficacy of anticancer medicines. Regulatory Research and Medicine Evaluation. 2019;9(1):34–40 (In Russ.) doi: 10.30895/1991-2919-2019-9-1-34-40
12. Ambrosone CB, Sweeney C, Coles BF, Thompson PA, McClure GY, Korourian S, Fares MY, Stone A, Kadlubar FF, Hutchins LF. Polymorphisms in glutathione S-transferases (GSTM1 and GSTT1) and survival after treatment for breast cancer. Cancer research. 2001; 61(19):7130–5.
13. Yang G, Shu XO, Ruan ZX, Cai QY, Jin F, Gao YT, Zheng W. Genetic polymorphisms in glutathione-S-transferase genes (GSTM1, GSTT1, GSTP1) and survival after chemotherapy for invasive breast carcinoma. Cancer. 2005;103(1):52–8. doi: 10.1002/cncr.20729
14. Gor PP, Su HI, Gray RJ, Gimotty PA, Horn M, Aplenc R, Vaughan WP, Tallman MS, Rebbeck TR, DeMichele A. Cyclophosphamidemetabolizing enzyme polymorphisms and survival outcomes after adjuvant chemotherapy for node-positive breast cancer: a retrospective cohort study. Breast cancer research: BCR. 2010;12(3):R26. doi: 10.1186/bcr2570
Review
For citations:
Gulian I.S., Bystritskaya E.P., Otstavnykh N.Y., Gulyan G.S., Hudchenko E.V., Eliseeva E.V., Isaeva M.P. Pharmacogenetic assessment of cytostatic therapy efficacy depending on the polymorphism of T1 and M1 glutathione-S-transferase genes in breast cancer patients. Pacific Medical Journal. 2024;(3):53-57. (In Russ.) https://doi.org/10.34215/1609-1175-2024-3-53-57