Relationship between ABCB1 gene polymorphisms and severe neutropenia in patients with breast cancer treated with doxorubicin/cyclophosphamide chemotherapy

Drug Metab Pharmacokinet. 2015 Apr;30(2):149-53. doi: 10.1016/j.dmpk.2014.09.009. Epub 2014 Nov 4.

Abstract

Chemotherapy-induced neutropenia is one of the major adverse events which results in the reduction of chemotherapy. Doxorubicin is a substrate of the adenosine triphosphate-binding cassette subfamily B member 1 (ABCB1) transporter; reportedly, ABCB1 polymorphisms influence doxorubicin pharmacokinetics. We evaluated the association between chemotherapy-induced neutropenia and ABCB1 polymorphisms in patients with breast cancer. We investigated 141 patients with breast cancer treated with doxorubicin and cyclophosphamide (AC) chemotherapy. Peripheral blood samples obtained from patients were genotyped for the ABCB1 2677G>T/A and 3435C>T polymorphisms. The genotypes were then investigated for their association with grade 3 or greater neutropenia, and further their risk factors were examined using a multivariate logistic regression. The proportion of patients with grade 3 or greater neutropenia was 85.7% in the homozygous variant group, and 80% and 58.6% in the heterozygous variant and GG genotype groups, respectively (p = 0.021). The multivariate logistic regression analysis revealed that the ABCB1 2677G>T/A polymorphism was a strong predictor of grade 3 or greater neutropenia (odds ratio: 3.76; 95% confidence interval: 1.44-9.81; p = 0.007). ABCB1 polymorphisms may influence the extent of chemotherapy-induced neutropenia in AC combination-treated patients with breast cancer.

Keywords: Adenosine triphosphate-binding cassette subfamily B member 1 polymorphism; Breast neoplasms; Cyclophosphamide; Doxorubicin; Neutropenia.

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily B / genetics
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Breast Neoplasms / drug therapy*
  • Chi-Square Distribution
  • Cyclophosphamide / adverse effects*
  • Doxorubicin / adverse effects*
  • Female
  • Gene Frequency
  • Genetic Predisposition to Disease
  • Heterozygote
  • Homozygote
  • Humans
  • Logistic Models
  • Middle Aged
  • Multivariate Analysis
  • Neutropenia / chemically induced*
  • Neutropenia / diagnosis
  • Neutropenia / genetics*
  • Odds Ratio
  • Phenotype
  • Polymorphism, Single Nucleotide*
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index

Substances

  • ABCB1 protein, human
  • ATP Binding Cassette Transporter, Subfamily B
  • Doxorubicin
  • Cyclophosphamide