Document Detail


Pharmacogenetics of fluoropyrimidine and cisplatin. A future application to gastric cancer treatment.
MedLine Citation:
PMID:  19638079     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Chemotherapy plays an important role in the treatment of gastric cancer both in adjuvant or advanced settings. Recent randomized trials in Japan have proved that S-1, a novel fluoropyrimidine derivative, and cisplatin are the most promising agents. However, both the efficacy and toxicity of a given regimen vary widely among patients due to the inherited variability of genes that involve drug anabolism and catabolism. A narrow therapeutic index of antitumor agents, i.e. a given regimen being too toxic and/or less effective to some segment of patients, prevents the overall improvement of treatment outcomes. Pharmacogenetics, a research field elucidating genetic polymorphism in drug metabolizing enzymes, may contribute to identifying patients who benefit from chemotherapy or who will experience life-threatening toxicity. There are several crucial enzymes identified involving anabolism and the catabolism of fluoropyrimidine and cisplatin, including dihydropyrimidine dehydrogenase, thymidylate synthase, orotate phosphoribosyl transferase, glutathione S transferase, and excision repair cross complementary group. Various polymorphisms and ethnic variabilities of these genes have been elucidated. This review highlights variations within biological functions, detection systems, and possible clinical applications of these enzymatic polymorphisms. This knowledge provides a tool to determine an optimum regimen according to the patient's drug metabolizing characteristics. This stance will contribute to establishing individualized therapies for gastric cancer, which offers superior efficacy with a minimal chance of severe toxicity.
Authors:
Shouji Shimoyama
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  24     ISSN:  1440-1746     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-07-29     Completed Date:  2010-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  970-81     Citation Subset:  IM    
Affiliation:
Gastrointestinal Unit, Settlement Clinic, Towa, Adachi-ku, Tokyo, Japan. shimoyama@apost.plala.or.jp
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MeSH Terms
Descriptor/Qualifier:
Antimetabolites, Antineoplastic / pharmacology*
Cisplatin / pharmacology*
DNA Repair
Dihydrouracil Dehydrogenase (NADP) / genetics
Drug Resistance, Neoplasm / genetics
Glutathione Transferase / genetics
Humans
Methylenetetrahydrofolate Reductase (NADPH2) / genetics
Orotate Phosphoribosyltransferase / genetics
Pharmacogenetics*
Pyrimidines / pharmacology*
Stomach Neoplasms / drug therapy*,  enzymology,  genetics*
Thymidylate Synthase / genetics
Chemical
Reg. No./Substance:
0/Antimetabolites, Antineoplastic; 0/Pyrimidines; 15663-27-1/Cisplatin; EC 1.3.1.2/Dihydrouracil Dehydrogenase (NADP); EC 1.5.1.20/Methylenetetrahydrofolate Reductase (NADPH2); EC 2.1.1.45/Thymidylate Synthase; EC 2.4.2.10/Orotate Phosphoribosyltransferase; EC 2.5.1.18/Glutathione Transferase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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