Personalized Medicine in Cancer Pain Management.

BACKGROUND: Previous studies have documented pain as an important concern for quality of life (QoL) and one of the most challenging manifestations for cancer patients. Thus, cancer pain management (CPM) plays a key role in treating pain related to cancer. The aim of this systematic review was to investigate CPM, with an emphasis on personalized medicine, and introduce new pharmacogenomics-based procedures for detecting and treating cancer pain patients. METHODS: This study systematically reviewed PubMed from 1990 to 2023 using keywords such as cancer, pain, and personalized medicine. A total of 597 publications were found, and after multiple filtering processes, 75 papers were included. In silico analyses were performed using the GeneCards, STRING-MODEL, miRTargetLink2, and PharmGKB databases. RESULTS: The results reveal that recent reports have mainly focused on personalized medicine strategies for CPM, and pharmacogenomics-based data are rapidly being introduced. The literature review of the 75 highly relevant publications, combined with the bioinformatics results, identified a list of 57 evidence-based genes as the primary gene list for further personalized medicine approaches. The most frequently mentioned genes were CYP2D6, COMT, and OPRM1. Moreover, among the 127 variants identified through both the literature review and data mining in the PharmGKB database, 21 variants remain as potential candidates for whole-exome sequencing (WES) analysis. Interestingly, hsa-miR-34a-5p and hsa-miR-146a-5p were suggested as putative circulating biomarkers for cancer pain prognosis and diagnosis. CONCLUSIONS: In conclusion, this study highlights personalized medicine as the most promising strategy in CPM, utilizing pharmacogenomics-based approaches to alleviate cancer pain.

Identification of miR-195-5p as a novel prognostic biomarker for colorectal cancer.

BACKGROUND: Recent evidence indicated that transcription patterns of microRNAs could be used as promising biomarkers for numerous cancers. It is stated that miR-195-5p could be used as a tumor suppressor in colorectal cancer (CRC). The purpose of the current work was to explore the transcription level of miR-195-5p and its clinical relevance in CRC patients. METHODS AND RESULTS: We used quantitative real-time polymerase chain reaction (qRT-PCR) to assess the tumor tissue sample of 140 CRC cases compared with normal adjacent tissue for the transcription of miR-195-5p and the clinicopathological relevance was statistically evaluated. We showed that tumor tissue miR-195-5p transcription was statistically downregulated in patients with CRC (median expression value 0.23, range 0.03-6.62) compared to normal adjacent tissue (median expression value 0.98, range 0.092-29.6, p < 0.001). The median transcription of miR-195-5p divided the CRC patients into miR-195-5p low-transcription (miR-195-5plow) and miR-195-5p high-transcription (miR-195-5phigh) groups. Furthermore, low miR-195-5p transcription level was statistically related with TNM stage, lymph node metastasis and tumor differentiation in CRC patients (all p-value < 0.05). Moreover, our results indicated that CRC cases with a decreased transcription level of miR-195-5p displayed a statistically shorter overall survival (OS) (p = 0.001) compared to higher miR-195-5p transcription. CONCLUSION: In conclusion, the finding proposes that miR-195-5p might be a valuable biomarker and a prognostic factor for CRC in the future.

Association and in silico investigations of miR-302c insertion/deletion variant as a novel biomarker with susceptibility to gastric cancer.

Gastric cancer (GC) is the fifth most prevalent malignant tumor and the third most frequent cause of cancer mortality worldwide. rs199971565 is an insertion/deletion (INDEL) located in microRNA-302c (miR-302c) seed site, which may affect its function and biogenesis. There is no genetic association study investigating this INDEL with any disease till now. Thus, the current study was conducted to investigate the association of rs199971565 with susceptibility to GC in an Iranian population. In addition, in silico studies were performed to reveal the possible functional significance of this INDEL. A total of 378 subjects were genotyped through amplification refractory mutation system PCR (ARMS-PCR) after DNA extraction from peripheral blood by the salting out procedure. Also, in silico analyses were performed through databases and web tools including MiRNASNP V2.0, miRWalk V2.0, miRTarBase, DAVID V6.8, RNAfold, PHDcleave, miRmap, and STarMir. Results revealed that there was an association between rs199971565 and the incidence risk of GC under a recessive (P = .04, odds ratio [OR] = 18.73; 95% confidence interval [CI] = 1.07-326.95) model of inheritance. Also, compared to the Ins allele, the Del allele significantly increased the risk of GC (P = .01, OR = 2.02; 95% CI = 1.11-3.66). Further analyses showed no significant association in age and sex between two study groups (P = .216 and P = .798, respectively). In conclusion, for the first time, this study indicated the association and in silico investigations of rs199971565 and suggested it as a novel INDEL biomarker located in the seed site of miR-302c, which may have crucial roles in the susceptibility to GC and its incidence risk.