GENETIC PREDICTORS OF TOXIC EFFECTS OF METHOTREXATE IN CANCER PATIENTS.

L Fishchuk, O Skavinska, O Ievseienkova, Z Rossokha, L Sheiko
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Abstract

Today, methotrexate (MTX) is used in combination with other medicines to treat a wide range of malignancies. Despite its proven high efficacy, MTX often causes serious side effects, which may result in the need to reduce the dose of MTX or discontinue the drug altogether. This, in turn, can provoke the development of MTX resistance and cancer progression. Predicting the risk of MTX-induced toxicity is currently difficult due to the variability of pharmacokinetics and pharmacodynamics in different patients, so the scientific literature is intensively searching for potential biomarkers. Based on the data available in the current literature, we analyzed the relationship between variants in the genes encoding the key components of MTX intracellular metabolism and the MTX-induced side effects and drug response. According to the results of our work, the most studied variants are those of the SLC19A1 gene, which encodes the reduced folate carrier protein 1, and the MTHFR gene, which encodes the enzyme methylenetetrahydrofolate reductase. Studies of the effect of methylation of the promoter regions of genes on the therapeutic effect of MTX are also very promising. In conclusion, the study of molecular genetic markers of MTX toxicity is extremely relevant and necessary because it can help to avoid the effect of multidrug resistance and improve the quality of life and survival of patients.

癌症患者甲氨蝶呤毒性效应的遗传预测因素。
如今,氨甲喋呤(MTX)与其他药物联用可治疗多种恶性肿瘤。尽管 MTX 已被证实具有很高的疗效,但它经常会引起严重的副作用,可能导致需要减少 MTX 的剂量或完全停药。这反过来又会引发MTX耐药性和癌症进展。由于不同患者的药代动力学和药效学存在差异,目前很难预测MTX诱发毒性的风险,因此科学文献正在深入研究潜在的生物标志物。根据现有文献中的数据,我们分析了编码 MTX 细胞内代谢关键成分的基因变异与 MTX 诱导的副作用和药物反应之间的关系。根据我们的研究结果,研究最多的变异是编码还原型叶酸载体蛋白 1 的 SLC19A1 基因和编码亚甲基四氢叶酸还原酶的 MTHFR 基因。基因启动子区域的甲基化对 MTX 治疗效果的影响研究也很有前景。总之,对 MTX 毒性的分子遗传标记进行研究是非常有意义和必要的,因为这有助于避免多药耐药性的影响,提高患者的生活质量和生存率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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