Understanding individual genetic variation can help predict chemotherapy side effects

March 23, 2012

The largest study ever on the effect of genetic variability on the toxicity of chemotherapy in breast cancer shows that it is possible to predict which patients are most likely to suffer serious side effects, a researcher will tell the 8th European Breast Cancer Conference (EBCC-8) today (Friday). Dr. Christof Vulsteke, from the Catholic University of Leuven, Belgium, will explain how his team's research is an important step towards achieving a personalised chemotherapy regime for each patient.

The researchers examined germline DNA from from 1089 who were treated between 2000 and 2010 with three commonly used chemotherapy drugs (fluorouracil, epirubicin and ). For each patient, the variability in the genes that are important for metabolising these three chemotherapeutic drugs was compared with the side effects experienced.

"We found that genetic variation in one gene was highly correlated with chemotherapy side effects," says Dr. Vulsteke. "Investigating this gene before starting chemotherapy would allow us to support the patient with either to increase the patient's immunity, or dose modifications, or a different better adapted to the patient, or a combination of these."

Currently, most patients receive the standard treatment; however, the side effects they suffer can be very different, ranging from severe to very minimal reactions. Making adjustments to treatment would have a major impact on both the physical and psychological well-being of patients, and on the to society posed by chemotherapy side effects, for example, hospitalisation.

The most important side effects of chemotherapy are mainly caused by immune system depression, which can result in potentially life threatening infections. Even though patients may take every precaution to avoid contamination, the vast majority of these infections are caused by naturally occurring microorganisms in the patient's own gastrointestinal tract. Other serious side effects noted in patients receiving chemotherapy are bleeding, severe infection of the mouth mucosa, severe bowel inflammation, nausea, and vomiting with dehydration.

"Our research has brought us one step closer towards prescribing personalised chemotherapy treatment with a minimum of side effects," says Dr. Vulsteke.

The researchers now intend to look for data from other European countries in order to further validate their results. They will also continue to follow up on their own patients; currently the patients are followed up, on average, for five years.

"In 2016 we will have a very accurate assessment of the impact of on survival and recurrence," says Dr. Vulsteke. "Our future research will focus on other genes involved in processing the chemotherapeutic drugs that we studied, and we will also enlarge the scope of the research by including other where we can hypothesise that genetic variability plays an equally important role," he will conclude.

Professor David Cameron, from the University of Edinburgh (Edinburgh, UK), and Chair of EBCC-8 said: "In the search for ways to "personalise" anti-cancer treatments, much of the focus has been on matching the treatment to the cancer. However it should not be forgotten that we also need to ensure the treatment is "matched" to the patient, and this study is an important step in this direction, potentially allowing us to ensure that standard chemotherapy can be delivered with either less severe toxicity, or perhaps to have the dose adjusted to give maximal benefit. Further studies will be needed to demonstrate that improvements in patient survival can be achieved by tailoring the actual doses along the lines that this study suggests could be possible."

Explore further: Breast cancer survivors struggle with cognitive problems several years after treatment

Related Stories

Breast cancer survivors struggle with cognitive problems several years after treatment

December 12, 2011
A new analysis has found that breast cancer survivors may experience problems with certain mental abilities several years after treatment, regardless of whether they were treated with chemotherapy plus radiation or radiation ...

New genomic test spares patients chemotherapy with no adverse effect on survival

March 22, 2012
Testing a breast cancer tumour for its genomic signature can help identify which patients will need adjuvant systemic therapy (additional chemotherapy) after surgery, and spare its use in those for whom it is not necessary, ...

Gene responsible for relapses in young leukemia patients

October 26, 2011
One of the causes of resistance to cancer treatment in children is now beginning to be elucidated. Acute lymphoblastic leukemia patients with a particular form of the ATF5 gene are at higher risk of having a relapse when ...

Recommended for you

Shooting the achilles heel of nervous system cancers

July 20, 2017
Virtually all cancer treatments used today also damage normal cells, causing the toxic side effects associated with cancer treatment. A cooperative research team led by researchers at Dartmouth's Norris Cotton Cancer Center ...

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

Definitive genomic study reveals alterations driving most medulloblastoma brain tumors

July 19, 2017
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75 percent of the brain tumors, including two new suspected cancer genes that were found exclusively in the least ...

Novel CRISPR-Cas9 screening enables discovery of new targets to aid cancer immunotherapy

July 19, 2017
A novel screening method developed by a team at Dana-Farber/Boston Children's Cancer and Blood Disorders Center—using CRISPR-Cas9 genome editing technology to test the function of thousands of tumor genes in mice—has ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.