국소진행성 직장암에서 Irinotecan을 이용한 술전보강화학방사선치료 시 UGT1A1 유전자 다형태의 유용성
The Efficacy of UGT1A1 Polymorphism in Chemoradiation Therapy Using Irinotecan in Patients with Locally Advanced Rectal Cancer
오승엽, 김영배, 전미선, 서광욱,
소속 상세정보
오승엽 ( Oh Seung-Yeop )
아주대학교 의과대학 외과학교실
김영배 ( Kim Young-Bae )
아주대학교 의과대학 병리학교실
전미선 ( Chun Mi-Son )
아주대학교 의과대학
서광욱 ( Suh Kwang-Wook )
아주대학교 의과대학 외과학교실
KMID : 0356720070230050344
Abstract
Purpose: Irinotecan (CPT-11) is hydrolyzed to an active SN-38, which is further detoxicated to SN-38G through conjugation by uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) enzymes. There are many reports that UGT1A1 polymorphisms are associated with irinotecan related dose-limiting toxicity. The aim of the present study is to determine whether UGT1A1 polymorphisms affect individual variations of the toxicity due to and the tumor response to irinotecan via the alteration of bioavailability of SN-38 in Korean patients with locally advanced rectal cancer.
Methods: Twenty patients with locally advanced rectal cancer, who had received surgery after irinotecan- containing chemoradiation from 2003 to 2006, were enrolled. We analyzed the association of UGT1A1 genotypes with toxicity and tumor response to chemoradiation therapy. A tumor response was assumed when a tumor regression grade I or II was obtained. Toxicity was graded in accordance with the NCI common toxicity criteria.
Results: The frequence of -53(TA)6＞7 (UGT1A1*28), 211G＞A (UGT1A1*6), 686C＞A (UGT1A1*27), -3279T＞G (UGT1A1*60), and -3156G＞A were 25% (5/20), 25% (5/20), 0% (0/20), 55% (11/20), and 20% (4/20), respectively. There were five grade III neutropenia and one severe diarrhea. Patients with UGT1A1*28 and -3156G＞A showed higher complete tumor response rates (40% vs. 6.7%, P=0.07; 50% vs. 6.3%, P=0.08), but there was no differences in toxicity and tumor response between responders and non-responders. Patients with -3279T＞G (UGT1A1*60) showed a tendency for lower tumor response in tumor responders, but there was no statistically significant difference (P=0.07).
Conclusions: This study suggested that -3279T＞G (UGT1A1*60) may be useful in predicting tumor response of irinotecan. In the future, further study is warranted using large numbers of cases to reach statistical significance.
키워드
UGT1A1;다형태;종양 반응;대장암
UGT1A1;Polymorphism;Tumor response;Colorectal cancer
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