Pharmacogenomics panel test for prevention toxicity in patient who receive Fluoropirimidine/Oxaliplatin-based therapy

R. Di Francia, R.S. Siesto, D. Valente*, D. Spartà**, M. Berretta***

Hematology-Oncology and Stem Cell transplantation Unit, National Cancer Institute, Fondazione “G. Pascale” IRCCS, Naples, Italy. rdifrancia@iapharmagen.org
*Italian Association of Pharmacogenomics and Molecular Diagnostics, Caserta, Italy
**Department of Surgery, University of Catania, Catania, Italy
***Department of Medical Oncology, CRO National Cancer Institute, Aviano, Pordenone, Italy

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• Pharmacogenomics

AIM: Both Fluoropirimidine and Oxaliplatin (FluOx) are the most common anticancer drugs used to treat lung, colorectal, ovarian, breast, head/neck, and genitourinary cancers. However, the efficacy of FluOx-based therapy is often compromised because of the severe risk of toxicity. Stratification of patients for multidrug response is a promising strategy for cancer treatment and personalized therapy.

METHODS: Here, we review the late findings on the most appropriate gene variants related to the toxicity in patients receiving FluOx chemotherapy. Several criteria were used to select a genotyping panel tests, including dihydropyrimidine dehydrogenase (DPYD), thymidylate synthase (TYMS), Glutathione S-transferase (GSTP1), and ATP-binding cassette, subfamily C member 2 (ABCC2).

RESULTS: Results of allelic status from 7 validated polymorphism assays, allow the stratification of the patients who are most likely to respond to FluOx treatments. Also, we will take in consideration the usefulness and costs of the methods used to detect these polymorphisms.

CONCLUSIONS: With these pharmacogenomics markers, the oncologists will have new means based on the genetic profile of the individual, to make treatment decisions for their patients in order to maximize benefits and minimize toxicity.

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