[1]孟安娜,李 杨.胃癌晚期患者CYP3A5*3基因多态性与阿帕替尼单药治疗不良反应的相关性研究[J].现代检验医学杂志,2024,39(01):1-4+105.[doi:10.3969/j.issn.1671-7414.2024.01.001]
 MENG Anna,LI Yang.Correlation between CYP3A5*3 Gene Polymorphism and Adverse Reactions of Apatinib Monotherapy in Patients with Advanced Gastric Cancer[J].Journal of Modern Laboratory Medicine,2024,39(01):1-4+105.[doi:10.3969/j.issn.1671-7414.2024.01.001]
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胃癌晚期患者CYP3A5*3基因多态性与阿帕替尼单药治疗不良反应的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年01期
页码:
1-4+105
栏目:
论著
出版日期:
2024-01-15

文章信息/Info

Title:
Correlation between CYP3A5*3 Gene Polymorphism and Adverse Reactions of Apatinib Monotherapy in Patients with Advanced Gastric Cancer
文章编号:
1671-7414(2024)01-001-05
作者:
孟安娜李 杨
(南京医科大学附属南京医院/ 南京市第一医院药学部,南京 210006)
Author(s):
MENG Anna LI Yang
(Department of Pharmacy, Nanjing Hospital Affiliated to Nanjing Medical University/ Nanjing First Hospital, Nanjing 210006, China)
关键词:
细胞色素P450 3A5*3基因多态性胃癌阿帕替尼不良反应
分类号:
R735.2;R730.43
DOI:
10.3969/j.issn.1671-7414.2024.01.001
文献标志码:
A
摘要:
目的 探讨胃癌晚期患者细胞色素P450 3A5*3(CYP3A5*3)基因多态性与阿帕替尼单药治疗不良反应的关系。方法 选取南京市第一医院2020 年1 月~ 2022 年6 月接受阿帕替尼单药治疗的胃癌晚期患者86 例。采集患者2ml 外周静脉血,采用限制性片段长度多态性聚合酶链反应(PCR-RFLP) 联合测序法鉴定患者CYP3A5*3 的基因型,分析其与阿帕替尼所致不良反应的相关性。结果 86 例患者中,突变杂合子型(AG 型)29 例,突变纯合子型(GG 型)51 例,突变型占比93.02%。携带CYP3A5*3 GG 基因型的患者高血压和白细胞减少的发生率明显高于AA+AG 基因型患者(χ2=6.154,6.947,P=0.043,0.027)。阿帕替尼治疗相关的其他不良反应未发现与CYP3A5*3 基因型的相关性(P> 0.05)。此外,未发现CYP3A5*3 基因型与严重不良反应的相关性(P > 0.05)。结论 CYP3A5*3 GG 基因型明显增加阿帕替尼单药治疗所致的高血压和白细胞减少发生风险,未发现其与严重不良反应发生风险的相关性。
Abstract:
Objective To investigate the relationship between cytochrome P450 3A5*3 (CYP3A5*3) gene polymorphism and adverse reactions of apatinib monotherapy in advanced gastric cancer patients. Methods A total of 86 patients with advanced gastric cancer who received apatinib monotherapy at Nanjing First Hospital from January 2020 to June 2022 were selected, and 2 ml of peripheral venous blood from patients was collected. The genotype of CYP3A5*3 was identified using PCR-RFLP combined sequencing method, and its correlation with adverse reactions was analyzed by apatinib. Results Among the 86 patients, there were 29 cases of mutant heterozygous genotype (AG genotype) and 51 cases of mutant homozygous genotype (GG genotype), with a mutation type accounting for 93.02%. The incidence of hypertension and leukopenia in patients with the CYP3A5*3 GG genotype was significantly higher than in patients with the AA+AG genotype (χ2=6.154, 6.947, P=0.043, 0.027). Other adverse reactions related to apatinib treatment were not found to be associated with the CYP3A5*3 genotype (P>0.05). In addition, no correlation was found between severe adverse reactions and the CYP3A5*3 genotype (P>0.05). Conclusion The CYP3A5*3 GG genotype significantly increased the risk of hypertension and leukopenia caused by apatinib monotherapy, and no correlation was found with the risk of serious adverse reactions.

参考文献/References:

[1] 李祥, 郑红梅, 吴奇, 等. 阿帕替尼在恶性肿瘤中的研究进展[J]. 临床外科杂志, 2017, 25(4):314-315. LI Xiang, ZHENG Hongmei, WU Qi, et al. Research progress of apatinib on malignant tumor[J]. Journal of Clinical Surgery, 2017, 25(4): 314-315.
[2] LI Jin, QIN Shukui, XU Jianming, et al. Apatinib for chemotherapy-refractory advanced metastatic gastric cancer: results from a randomized, placebo-controlled, parallel-arm, phase II trial[J]. Journal of Clinical Oncology, 2013, 31(26): 3219-3225.
[3] LESCHE D, SIGURDARDOTTIR V, SETOUD R, et al. CYPP3A5*3 and PPOR*28 genetic variants influence the required dose of tacroloimus in heart transplant recipients[J]. Therapeutic Drug Monitoring, 2014, 36(6): 710-715.
[4] LIU Jiayong, ZHU Baorang, WANG Yudong, et al. The efficacy and safety of apatinib mesylate in the treatment of metastatic osteosarcoma patients who progressed after standard therapy and the VEGFR2 gene polymorphism analysis[J]. International Journal of Clinical Oncology, 2020, 25(6): 1195-1205.
[5] SONG Zizheng, ZHAO Lifen, ZUO Jing, et al. Clinical outcomes and safety of apatinib mesylate in the treatment of advanced non-squamous nonsmall cell lung cancer in patients who progressed after standard therapy and analysis of the KDR gene polymorphism[J]. Onco Targets and Therapy, 2020, 13: 603-613.
[6] GENG Nan, DING Cuimin, LIU Zhikun, et al. Influence of VEGFR2 gene polymorphism on the clinical outcomes of apatinib for patients with chemotherapy-refractory extensive-stage SCLC: a realworld retrospective study[J]. International Journal of Clinical Oncology, 2021, 26(4): 670-683.
[7] YAN Zhen, GU Yuanyuan, HU Xiaodi, et al. Clinical outcomes and safety of apatinib monotherapy in the treatment of patients with advanced epithelial ovarian carcinoma who progressed after standard regimens and the analysis of the VEGFR2 polymorphism[J].Oncology Letters, 2020, 20(3): 3035-3045.
[8] 赵瑞华, 周亚楠, 李鹤, 等. 阿帕替尼对晚期非小细胞肺癌患者的疗效及VEGFR2-906T>C 多态性位点的影响[J]. 中华医学杂志, 2019, 99(2): 105-110. ZHAO Ruihua, ZHOU Ya’nan, LI He, et al. Influence of apatinib and VEGFR2-906T>C polymorphism on clinical outcomes of advanced non-small cell lung cancer patients[J]. National Medical Journal of China, 2019, 99(2): 105-110.
[9] 石瑶瑶. 阿帕替尼治疗恶性肿瘤不良反应的单中心观察性研究[D]. 济南:山东大学, 2017:1-44. SHI Yaoyao. Single-center observational study of adverse drug reaction of apatinib utilized in malignant tumor therapy[D]. Jinan: Shandong University, 2017: 1-44.
[10] 曹烨, 万邦喜, 苏敏实. 药物临床试验安全评价·广东共识(2020 年版)[J]. 今日药学, 2020, 30(11): 731-740. CAO Ye, WANG Bangxi, SU Minshi. Consensus of expert on safety evaluation of drug clinical trial in Guangdong (Version 2020)[J]. Pharmacy Today, 2020, 30(11): 731-740.
[11] U. S. Department of Health and Human Services. Common Terminology Criteria for Adverse Events (CTCAE) Version 5. 0[EB/OL]. (2017-11-27)(2023-07-18). https://ctep. cancer. gov/protocoldevelopment/electronic_applications/docs/ctcae_v5_quick_reference_5x7. pdf.
[12] GU Xiaoying, ZHANG Su, YANG Xuejiao, et al. Drugrelated adverse events potentially predict the efficacy of apatinib on advanced hepatocellular carcinoma[J].BMC Gastroenterology, 2022, 22(1): 1-9.
[13] 郭九叶, 耿珊珊, 高月乔, 等. 北京地区新生儿细胞色素P450 单核苷酸多态性及其代谢表型分布的研究[J]. 现代检验医学杂志, 2018, 33(6): 9-12. GUO Jiuye, GENG Shanshan, GAO Yueqiao, et al. Distribution of single nucleotide polymorphisms of cytochrome P450 genes and metabolic phenotypes of newborn infants in Beijing area[J]. Journal of Modern Laboratory Medicine, 2018, 33(6): 9-12.
[14] NEYSHABURINEZHAD N, GHASIM H, ROUINI M, et al. Frequency of important CYP450 enzyme gene polymorphisms in the Iranian population in comparison with other major populations: a comprehensive review of the human data[J]. Journal of Personalized Medicine, 2021, 11(8): 804.
[15] 平军娇, 高永双, 邓顺顺, 等. 广东省中山地区汉族精神类疾病患者药物基因型及代谢表型分布研究[J]. 现代检验医学杂志, 2019, 34(3): 15-20, 24. PING Junjiao, GAO Yongshuang, DENG Shunshun, et al. Research on characteristics of drug genotypes and metabolic phenotypes in Chinese Han patients with severe mental illness in Zhongshan area of Guangdong province[J]. Journal of Modern Laboratory Medicine, 2019, 34(3): 15-20, 24.
[16] LI Jin, QIN Shukui, XU Jianming, et al. Randomized, double-blind, placebo-controlled phase III trial of apatinib in patients with chemotherapy-refractory advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction[J]. Journal of Clinical Oncology, 2016, 34(13): 1448-1454.
[17] 范芳, 余炜, 刘捷, 等. 真实世界中阿帕替尼血药浓度研究[J]. 临床合理用药杂志, 2020, 13(5):117-118. FAN Fang, YU Wei, LIU Jie, et al. The study on plasma concentration of apatinib in the real world[J].Chinese Journal of Clinical Rational Drug Use, 2020, 13(5): 117-118.
[18] L? Yajuan, ZHANG Yan, ZHANG Jiandong, et al. Reversible posterior leukoencephalopathy syndrome following apatinib for gastric cancer in an adult:a case report and a review of the literature[J].Medicine(Baltimore), 2019, 98(46): e17787.
[19] 贾贝, 乔涌起, 范琳琳, 等. 一例贲门癌患者服用阿帕替尼发生缺血性脑卒中的病例分析[J]. 实用药物与临床,2020, 23(2): 176-180. JIA Bei, QIAO Yongqi, FAN Linlin, et al. Ischemic stroke due to taking apatinib in a patient with gastric cardia aderocarcinoma: a case report[J]. Practical Pharmacy and Clinical Remedies, 2020, 23(2): 176-180.
[20] REN Dengfeng, WANG Guoxin, ZHANG Yu, et al. Efficacy and safety of apatinib for elderly patients with advanced or metastatic gastric cancer after failure of at least first-line chemotherapy: a multi-center, singlearm, Phase II Study. [J]. Onco Targets and Therapy, 2021, 14: 4499-4508.
[21] ZHANG Yong, HAN Chun, LI Juan, et al. Efficacy and safety for apatinib treatment in advanced gastric cancer:a real world study[J]. Scientific Reports, 2017, 7(1): 13208.

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备注/Memo

备注/Memo:
基金项目: 江苏省南京药学会常州四药医院药学科研项目(NO.2019YX013):CYP3A4*1G/18B 及CYP3A5*3 基因多态性对晚期胃癌患者阿帕替尼稳态血药浓度及不良反应影响的研究。
作者简介:孟安娜(1992-),女,硕士,药师,主要从事抗肿瘤临床药学工作,E-mail: 445603172@qq.com。
通讯作者:李杨,副主任药师,研究方向:临床药学与合理用药,E-mail: yangli2008pharma@163.com。
更新日期/Last Update: 2024-01-15