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Association of CASP3 polymorphism with hematologic toxicity in patients with advanced non-small-cell lung carcinoma treated with platinum-based chemotherapy.

ABSTRACT: Apoptosis is a distinct mode of cell death that is responsible for the deletion of cells in tumors and in normal tissues. We pursued a pathway-based approach to investigate the association of potentially functional genetic polymorphisms of the corresponding genes with the outcomes of platinum-based chemotherapy in advanced non-small-cell lung cancer (NSCLC). A MALDI-TOF mass spectrometer was used for genotyping 10 polymorphisms of eight apoptosis-related genes, including BCL2 rs1801018, rs1564483, rs2279115, BAX rs4645878, caspase (CASP3) rs6948, CASP8 rs3834129, CASP10 rs13006529, rs3900115, tumor necrosis factor ? (TNF?) rs1800629, and macrophage migration inhibitory factor (MIF) rs755622. The associations between these single nucleotide polymorphisms and the outcomes of 445 advanced NSCLC patients treated with platinum-based chemotherapy were evaluated. The CASP3 rs6948 polymorphism was most significantly associated with hematologic toxicity in a dose-dependent manner. The incidence of severe hematologic toxicity was significantly lower in C allele carriers (P = 0.005; odds ratio = 0.524; 95% confidence interval = 0.333-0.824) and still significant after a Bonferroni correction. The function of this single nucleotide polymorphism in gene expression was also investigated. Quantitative PCR showed that individuals with the C allele had lower levels of CASP3 transcripts in peripheral blood lymphocytes. Luciferase reporter assays showed that the minor C allele significantly decreased the reporter gene expression level. In addition, the TNF? rs1800629 mutant allele significantly elevated gastrointestinal toxicity (P = 0.020; odds ratio = 3.020; 95% confidence interval = 1.188-7.676), when compared to the wild-type homozygote. No other association was found. In conclusion, for the first time, our study suggests that CASP3 rs6948 might influence CASP3 expression and be associated with severe hematologic toxicity risk.

SUBMITTER: Gu S

PROVIDER: S-EPMC7659371 | biostudies-literature | 2012 Aug

REPOSITORIES: biostudies-literature

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Association of CASP3 polymorphism with hematologic toxicity in patients with advanced non-small-cell lung carcinoma treated with platinum-based chemotherapy.

Gu Shaohua S Wu Qihan Q Zhao Xueying X Wu Wenting W Gao Zhiqiang Z Tan Xiaoming X Qian Ji J Chen Hongyan H Xie Yi Y Jin Li L Han Baohui B Lu Daru D

Cancer science 20120618 8

Apoptosis is a distinct mode of cell death that is responsible for the deletion of cells in tumors and in normal tissues. We pursued a pathway-based approach to investigate the association of potentially functional genetic polymorphisms of the corresponding genes with the outcomes of platinum-based chemotherapy in advanced non-small-cell lung cancer (NSCLC). A MALDI-TOF mass spectrometer was used for genotyping 10 polymorphisms of eight apoptosis-related genes, including BCL2 rs1801018, rs156448 ...[more]

PMID: 22568453

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Project description:Background and objectiveOverexpression of COX-2 is proved to contribute to tumor promotion and carcinogenesis through stimulating cell proliferation, inhibiting apoptosis and enhancing the invasiveness of cancer cells. Apoptosis-related molecules are potential predictive markers for survival and toxicity in platinum treatment. This study aimed at investigating the association between COX-2 polymorphisms and the occurrence of grade 3 or 4 toxicity in advanced non-small cell lung cancer patients treated with platinum-based chemotherapy.Materials and methodsTwo hundred and twelve patients with inoperable stage IIIB-IV NSCLC received first-line chemotherapy between 2007 and 2009 were recruited in this study. Four functional COX-2 polymorphisms were genotyped by PCR-based restriction fragment length polymorphism (RFLP) methods.ResultsThe incidence of grade 3 or 4 hematologic toxicity was significantly higher in G allele carriers of the COX-2 rs689466 (-1195G/A) polymorphism compared with wild-type homozygotes AA (P value = 0.008; odds ratio, 2.47; 95% confidence internal, 1.26-4.84) and the significance still existed after the Bonferroni correction. Statistically significant difference was also found in grade 3 or 4 leukopenia (P value = 0.010; OR = 2.82; 95%CI = 1.28-6.20). No other significant association was observed between genotype and toxicity in the study. The haplotype analysis showed that the haplotype AGG was associated with a reduced risk of grade 3 or 4 hematologic and leukopenia toxicity (P value = 0.009; OR = 0.59; 95%CI = 0.39-0.88 and P value = 0.025; OR = 0.61; 95%CI = 0.39-0.94, respectively) while the haplotype GGG was associated with an increased risk of grade 3 or 4 hematologic and leukopenia toxicity (P value = 0.009; OR = 1.71; 95%CI = 1.14-2.56 and P value = 0.025; OR = 1.65; 95%CI = 1.06-2.57, respectively).ConclusionThis investigation for the first time suggested that polymorphism in COX-2 rs689466 may be a potent bio-marker in predicting severe hematologic toxicity in NSCLC patients after platinum-based chemotherapy.

Project description:Purpose:Hematologic toxicity (HT) during chemoradiation therapy (CRT) for anal cancer can lead to treatment breaks that compromise efficacy. We hypothesized that CRT-induced HT correlates with changes in active bone marrow (ABM) characterized by pre-/post-CRT positron emission tomography (PET)/computed tomography. Methods and materials:Data from 36 patients with anal cancer who were treated with 18F-fluorodeoxyglucose PET/computed tomography scans 2 weeks before and 6 to 16 weeks after CRT were analyzed. Complete blood counts with differential within 2 weeks from, weekly during, and 2 week after treatment were obtained. HT was defined as baseline complete blood count change to nadir and posttreatment recovery. Total bone marrow was segmented into 2 subregions: lumbosacral (LS) pelvis (L5 vertebrae, sacrum, and coccyx) and lower pelvis (LP) (ilium, femoral head/neck, and greater and lesser trochanter). PET ABM was characterized as the volume having standard uptake value (SUV) greater than the mean uptake of unirradiated extrapelvic bone marrow. PET variables of pre-/post-CRT and HT predictors were analyzed by linear regression. Results:Average pelvic ABM was significantly reduced from 52% to 41% in pre- to post-CRT PET scans for all patients (P = .0012). Regional analysis indicated significant post-CRT reduction of LS-ABM (P < .0001) and LP-ABM (P = .006). Linear regression analysis identified post-CRT SUVmean, differential ?SUVmean, and ?ABM as correlating significantly with pre- and posttreatment HT. ?WBC linearly correlated with ?ABM of LS and LP pelvis (P = .033 and P = .028, respectively). Dosimetrically, ABM was sensitive to higher radiation doses (>50 Gy) in terms of acute hematologic ?WBC (P = .021) and ?ANC(P = .028). HT increased with increasing volume of ABM receiving 40 Gy. The results also suggest that ABM V40 Gy ? 20% to 25% may significantly reduce the risk of HT. Conclusions:HT was significantly associated with ?ABM in patients with anal cancer who were treated with CRT. LS-ABM was a robust surrogate for evaluating CRT-induced HT. Our results suggest implementation of ABM dosimetric constraints, V40 Gy ? 20-25%, may significantly reduce HT and lead to decreased treatment delays associated with clinical outcomes.

Project description:We developed a computational platform including machine learning and a mechanistic mathematical model to find the optimal protocol for administration of platinum-doublet chemotherapy in a palliative setting. The platform has been applied to advanced metastatic non-small cell lung cancer (NSCLC). The 42 NSCLC patients treated with palliative intent at Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, were collected from a retrospective cohort of patients diagnosed in 2004-2014. Patients were followed-up, for three years. Clinical data collected include complete information about the clinical course of the patients including treatment schedule, response according to RECIST classification, and survival. The core of the platform is the mathematical model, in the form of a system of ordinary differential equations, describing dynamics of platinum-sensitive and platinum-resistant cancer cells and interactions reflecting competition for space and resources. The model is simulated stochastically by sampling the parameter values from a joint probability distribution function. The machine learning model is applied to calibrate the mathematical model and to fit it to the overall survival curve. The model simulations faithfully reproduce the clinical cohort at three levels long-term response (OS), the initial response (according to RECIST criteria), and the relationship between the number of chemotherapy cycles and time between two consecutive chemotherapy cycles. In addition, we investigated the relationship between initial and long-term response. We showed that those two variables do not correlate which means that we cannot predict patient survival solely based on the initial response. We also tested several chemotherapy schedules to find the best one for patients treated with palliative intent. We found that the optimal treatment schedule depends, among others, on the strength of competition among various subclones in a tumor. The computational platform developed allows optimizing chemotherapy protocols, within admissible limits of toxicity, for palliative treatment of metastatic NSCLC. The simplicity of the method allows its application to chemotherapy optimization in different cancers.

Project description:BackgroundIn addition to radiological evaluation, biomarkers may be useful in providing early information on the response to treatment, and supporting clinical decision-making. The objective of this study was to investigate carcinoembryonic antigen (CEA) and lactate dehydrogenase (LDH) as biomarkers for early assessment of response in patients with advanced non-small cell lung cancer (NSCLC) treated with platinum-based chemotherapy.MethodsA retrospective follow-up study was conducted from 2012 to 2017 among 593 consecutive patients with advanced NSCLC treated with first-line platinum-based chemotherapy in a large teaching hospital in the Netherlands. Pretreatment biomarker levels and changes from pretreatment levels were studied for association with radiologic response (partial response [PR] or complete response [CR], according to RECIST 1.1) using multivariate logistic regression, and with overall survival using COX proportional hazard modeling. Patient and disease characteristics such as age and disease stage were taken into account as potential confounding factors.ResultsDecreases in CEA and LDH (≥ 20%), particularly early in treatment, were significantly associated with better radiological response. Increases in these biomarkers (≥ 20%) and high pretreatment LDH levels (≥ 247 U/L) were significantly associated with lower overall survival.ConclusionsOur results support determination of CEA and LDH levels for earlier assessment of response to platinum-based chemotherapy in patients with advanced NSCLC. Hence, routine determination and evaluation of CEA and LDH levels, prior to each cycle of platinum-based chemotherapy in advanced NSCLC, should be considered as part of daily clinical practice.Key pointsSIGNIFICANT FINDINGS OF THE STUDY: Serum biomarkers in monitoring of treatment in advanced NSCLC would be useful. CEA and LDH decrease (≥ 20%) is favorable for achieving radiological response. High LDH levels and CEA/LDH increase (≥ 20%) is associated with reduced survival.What this study addsMonitoring of CEA seems to be particularly relevant in early stage of treatment. CEA and LDH determination should be considered as part of daily clinical practice.

Dataset Information

Association of CASP3 polymorphism with hematologic toxicity in patients with advanced non-small-cell lung carcinoma treated with platinum-based chemotherapy.

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Association of CASP3 polymorphism with hematologic toxicity in patients with advanced non-small-cell lung carcinoma treated with platinum-based chemotherapy.

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