Functional polymorphisms in xenobiotic metabolizing enzymes and their impact on the therapy of breast cancer
Breast cancer is the top cancer among women, and its incidence is increasing worldwide. Although the mortality tends to decrease due to early detection and treatment, there is great variability in the rates of clinical response and survival, which makes breast cancer one of the most appealing target...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2013-01-01
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| Series: | Frontiers in Genetics |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fgene.2012.00329/full |
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| author | Rosane eVianna-Jorge Rosane eVianna-Jorge Juliana eFesta-Vasconcellos Juliana eFesta-Vasconcellos Sheyla Mria Torres Goulart-Citrangulo Marcelo Sobral Leite Marcelo Sobral Leite |
| author_facet | Rosane eVianna-Jorge Rosane eVianna-Jorge Juliana eFesta-Vasconcellos Juliana eFesta-Vasconcellos Sheyla Mria Torres Goulart-Citrangulo Marcelo Sobral Leite Marcelo Sobral Leite |
| author_sort | Rosane eVianna-Jorge |
| collection | DOAJ |
| description | Breast cancer is the top cancer among women, and its incidence is increasing worldwide. Although the mortality tends to decrease due to early detection and treatment, there is great variability in the rates of clinical response and survival, which makes breast cancer one of the most appealing targets for pharmacogenomic studies. The recognition that functional CYP2D6 polymorphisms affect tamoxifen pharmacokinetics has motivated the attempts of using CYP2D6 genotyping for predicting breast cancer outcomes. In addition to tamoxifen, the chemotherapy of breast cancer includes combinations of cytotoxic drugs, which are substrates for various xenobiotic metabolizing enzymes. Because of these drugs’ narrow therapeutic window, it has been postulated that impaired biotransformation could lead to increased toxicity. In the present review, we performed a systematic search of all published data exploring associations between polymorphisms in xenobiotic metabolizing enzymes and clinical outcomes of breast cancer. We retrieved 43 original articles involving either tamoxifen or other chemotherapeutic protocols, and compiled all information regarding response or toxicity. The data indicate that, although CYP2D6 polymorphisms can indeed modify tamoxifen pharmacokinetics, CYP2D6 genotyping alone is not enough for predicting breast cancer outcomes. The studies involving other chemotherapeutic protocols explored a great diversity of pharmacogenetic targets, but the number of studies for each functional polymorphism is still very limited, with usually no confirmation of positive associations. In conclusion, the application of pharmacogenetics to predict breast cancer outcomes and to select one individual’s chemotherapeutic protocol is still far from clinical routine. Although some very interesting results have been produced, no clear practical recommendations are recognized yet. |
| first_indexed | 2024-04-12T09:29:00Z |
| format | Article |
| id | doaj.art-4882f6140fbc421ca28f8fa226be59c7 |
| institution | Directory Open Access Journal |
| issn | 1664-8021 |
| language | English |
| last_indexed | 2024-04-12T09:29:00Z |
| publishDate | 2013-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Genetics |
| spelling | doaj.art-4882f6140fbc421ca28f8fa226be59c72022-12-22T03:38:24ZengFrontiers Media S.A.Frontiers in Genetics1664-80212013-01-01310.3389/fgene.2012.0032940216Functional polymorphisms in xenobiotic metabolizing enzymes and their impact on the therapy of breast cancerRosane eVianna-Jorge0Rosane eVianna-Jorge1Juliana eFesta-Vasconcellos2Juliana eFesta-Vasconcellos3Sheyla Mria Torres Goulart-Citrangulo4Marcelo Sobral Leite5Marcelo Sobral Leite6Instituto Nacional de CâncerUniversidade Federal do Rio de JaneiroInstituto Nacional de CâncerUniversidade Federal do Rio de JaneiroInstituto Nacional de CâncerInstituto Nacional de CâncerUniversidade Federal do Rio de JaneiroBreast cancer is the top cancer among women, and its incidence is increasing worldwide. Although the mortality tends to decrease due to early detection and treatment, there is great variability in the rates of clinical response and survival, which makes breast cancer one of the most appealing targets for pharmacogenomic studies. The recognition that functional CYP2D6 polymorphisms affect tamoxifen pharmacokinetics has motivated the attempts of using CYP2D6 genotyping for predicting breast cancer outcomes. In addition to tamoxifen, the chemotherapy of breast cancer includes combinations of cytotoxic drugs, which are substrates for various xenobiotic metabolizing enzymes. Because of these drugs’ narrow therapeutic window, it has been postulated that impaired biotransformation could lead to increased toxicity. In the present review, we performed a systematic search of all published data exploring associations between polymorphisms in xenobiotic metabolizing enzymes and clinical outcomes of breast cancer. We retrieved 43 original articles involving either tamoxifen or other chemotherapeutic protocols, and compiled all information regarding response or toxicity. The data indicate that, although CYP2D6 polymorphisms can indeed modify tamoxifen pharmacokinetics, CYP2D6 genotyping alone is not enough for predicting breast cancer outcomes. The studies involving other chemotherapeutic protocols explored a great diversity of pharmacogenetic targets, but the number of studies for each functional polymorphism is still very limited, with usually no confirmation of positive associations. In conclusion, the application of pharmacogenetics to predict breast cancer outcomes and to select one individual’s chemotherapeutic protocol is still far from clinical routine. Although some very interesting results have been produced, no clear practical recommendations are recognized yet.http://journal.frontiersin.org/Journal/10.3389/fgene.2012.00329/fullchemotherapybreast cancerToxicitygene polymorphismsefficacyhormone therapy |
| spellingShingle | Rosane eVianna-Jorge Rosane eVianna-Jorge Juliana eFesta-Vasconcellos Juliana eFesta-Vasconcellos Sheyla Mria Torres Goulart-Citrangulo Marcelo Sobral Leite Marcelo Sobral Leite Functional polymorphisms in xenobiotic metabolizing enzymes and their impact on the therapy of breast cancer Frontiers in Genetics chemotherapy breast cancer Toxicity gene polymorphisms efficacy hormone therapy |
| title | Functional polymorphisms in xenobiotic metabolizing enzymes and their impact on the therapy of breast cancer |
| title_full | Functional polymorphisms in xenobiotic metabolizing enzymes and their impact on the therapy of breast cancer |
| title_fullStr | Functional polymorphisms in xenobiotic metabolizing enzymes and their impact on the therapy of breast cancer |
| title_full_unstemmed | Functional polymorphisms in xenobiotic metabolizing enzymes and their impact on the therapy of breast cancer |
| title_short | Functional polymorphisms in xenobiotic metabolizing enzymes and their impact on the therapy of breast cancer |
| title_sort | functional polymorphisms in xenobiotic metabolizing enzymes and their impact on the therapy of breast cancer |
| topic | chemotherapy breast cancer Toxicity gene polymorphisms efficacy hormone therapy |
| url | http://journal.frontiersin.org/Journal/10.3389/fgene.2012.00329/full |
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