Irinotecan-induced toxicity pharmacogenetics: an umbrella review of systematic reviews and meta-analyses.
Pharmacogenomics J
; 17(1): 21-28, 2017 01.
Article
in En
| MEDLINE
| ID: mdl-27503581
ABSTRACT
Irinotecan chemotherapy toxicities can be severe, and may result in treatment delay, morbidity and in some rare cases death. This systematic review of systematic reviews synthesises all meta-analyses on biomarkers for irinotecan toxicity across all genetic models for Asians, Caucasians, low dose, medium/high dose and regimens with and without fluorouracil. False-positive findings are a problem in pharmacogenetics, increasing the importance of systematic reviews. Four systematic reviews that investigated the effect of the polymorphisms UGT1A1*6 and/or*28 on neutropenia or diarrhoea toxicity were included. Both UGT1A1*6 and *28 were reliably demonstrated to be risk factors for irinotecan-induced neutropenia, with tests for both polymorphisms potentially being particularly useful in Asian cancer patients. UGT1A1*6 and *28 were also related to diarrhoea toxicity; however, at low doses of irinotecan there was evidence that UGT1A1*28 was not. In synthesising the best available evidence, this umbrella systematic review provides a novel reference for clinicians applying personalised medicine and identifies important research gaps.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pharmacogenetics
/
Camptothecin
/
Meta-Analysis as Topic
/
Glucuronosyltransferase
/
Polymorphism, Single Nucleotide
/
Diarrhea
/
Pharmacogenomic Variants
/
Systematic Reviews as Topic
/
Neutropenia
/
Antineoplastic Agents, Phytogenic
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limits:
Humans
Language:
En
Journal:
Pharmacogenomics J
Journal subject:
BIOLOGIA MOLECULAR
/
FARMACOLOGIA
Year:
2017
Document type:
Article
Affiliation country: