Profiling of drug-metabolizing enzymes/transporters in CD33+ acute myeloid leukemia patients treated with Gemtuzumab-Ozogamicin and Fludarabine, Cytarabine and Idarubicin

Pharmacogenomics J. 2013 Aug;13(4):335-41. doi: 10.1038/tpj.2012.13. Epub 2012 May 15.

Abstract

Genetic heterogeneity in drug-metabolizing enzyme/transporter (DMET) genes affects specific drug-related cancer phenotypes. To investigate the relationships between genetic variation and response to treatment in acute myeloid leukemia (AML), we genotyped 1931 variants on DMET genes in 94 CD33-positive AML patients enrolled in a phase III multicenter clinical trial combining Gemtuzumab-Ozogamicin (GO) with Fludarabine-Cytarabine-Idarubicin (FLAI) regimen, with the DMET Plus platform. Two ADH1A variants showed statistically significant differences (odds ratio (OR)=5.68, P=0.0006; OR=5.35, P=0.0009) in allele frequencies between patients in complete/partial remission and patients without response, two substitutions on CYP2E1 (OR=0.13, P=0.001; OR=0.09, P=0.003) and one on SLCO1B1 (OR=4.68, P=0.002) were found to differently influence liver toxicity, and two nucleotide changes on SULTB1 and SLC22A12 genes correlated with response to GO (OR=0.24, P=0.0009; OR=2.75, P=0.0029). Genetic variants were thus found for the first time to be potentially associated with differential response and toxicity in AML patients treated with a combination of GO-FLAI regimen.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aminoglycosides / administration & dosage
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Cytarabine / administration & dosage
  • Enzymes / genetics*
  • Enzymes / metabolism
  • Female
  • Gemtuzumab
  • Genetic Heterogeneity
  • Genotype
  • Humans
  • Idarubicin / administration & dosage
  • Inactivation, Metabolic / genetics*
  • Leukemia, Myeloid, Acute / drug therapy*
  • Leukemia, Myeloid, Acute / genetics*
  • Leukemia, Myeloid, Acute / pathology
  • Male
  • Neoplasm Recurrence, Local / drug therapy
  • Sialic Acid Binding Ig-like Lectin 3 / genetics
  • Treatment Outcome
  • Vidarabine / administration & dosage
  • Vidarabine / analogs & derivatives

Substances

  • Aminoglycosides
  • Antibodies, Monoclonal, Humanized
  • CD33 protein, human
  • Enzymes
  • Sialic Acid Binding Ig-like Lectin 3
  • Cytarabine
  • Gemtuzumab
  • Vidarabine
  • fludarabine
  • Idarubicin