Predictors of irinotecan toxicity and efficacy in treatment of metastatic colorectal cancer.
Acta Medica (Hradec Kralove)
; 55(4): 153-9, 2012.
Article
in En
| MEDLINE
| ID: mdl-23631285
ABSTRACT
The colorectal cancer ranks high among the malignant tumours in incidence and mortality and irinotecan is standardly used in palliative treatment of metastatic disease in every therapeutic line. Unfortunately, the treatment with irinotecan is often associated with severe toxicities, especially neutropenia and diarrhea. The majority of the toxic manifestation is caused by the insufficient deactivation (glucuronidation) of irinotecan active metabolite SN-38 by UGT1A enzyme. The elevated SN-38 plasma concentration is responsible for the hematological and gastrointestinal toxicity that can become life-threatening. The patients carrying the mutation of the gene encoding UGT1A enzyme lack the ability of bilirubin glucuronidation, and suffer from the inherited un-conjugated hyperbilirubinemia (Gilbert syndrome, Crigler-Najjar type 1 and 2 syndrome). The mutations in other enzyme systems also play role in the etiopathogenesis of the irinotecan toxicity CYP3A (cytochrome P-450), ABC family of transmembrane transporters (adenosine-triphosphate binding cassette). The goal of the contemporary research is to determine the predictive factors that will enable the individual adjustment of the individual drug dosage while minimising the adverse effects and maintaining the treatment benefit.
Search on Google
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Camptothecin
/
Colorectal Neoplasms
/
Antineoplastic Agents, Phytogenic
Type of study:
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Acta Medica (Hradec Kralove)
Journal subject:
MEDICINA
Year:
2012
Type:
Article
Affiliation country:
Czech Republic