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Glutathione-S-transferase (GST) polymorphisms influence cisplatin elimination and toxicity to treatment in patients with scamous cell carcinoma of head and neck
3rd International Conference on Clinical Pharmacy
Pincinato E C1, 2, Costa A P L1, Lopes-Aguiar L1, Costa E F D1, Nogueira G A S1, Lima T R P1, Moriel P1 and Lima C S P1
1University of Campinas, Brazil
2Mackenzie Presbyterian University, Brazil
Cisplatin (CDDP) plus Radiotherapy (RT) is commonly used for treatment of Scamous Cell Carcinoma of Head and Neck
(SCCHN). However, patients with the same clinical and tumor aspects present different toxicities to treatment. Glutathione-Stransferases
participate in CDDP excretion from the cells and may contribute to distinct toxicities to CDDP plus RT. GSTM1 and
GSTT1 genes have null variant genotypes, in which enzymes are absent. Val allele of GSTP1 Ile105Val polymorphism encodes enzyme
with lower activity than that encoded by Ile allele. The aims of this work were to evaluate the influence of GSTs polymorphisms
on toxicity induced by CDDP and its elimination in urine of patients with SCCHN. Ninety SCCHN patients received 35 sessions
of RT plus three infusions of CDDP (75-100 mg/m�²). DNA was obtained from blood samples and urine was obtained 0-48 hours
after CDDP administration. Vomiting, ototoxicity and nephrotoxicity were evaluated using conventional criteria, urinary CDDP
was detected by HPLC-UV, and GSTs genotypes were identified using multiplex PCR or PCR and enzymatic digestion. Patients with
GSTT1 null genotype presented less vomiting (20.0% vs. 64.4%; p=0.002), ototoxicity (41.7% vs. 79.3%; p=0.03), and nephrotoxicity
(62.87�±20.72 vs. 69.94�±21.40 EDTA-51Cr mL/min/1.73 m�²; p=0.03) than those with GSTT1 genes. Patients with GSTP1 IleIle genotype
eliminated less CDDP in urine than those with Ile/Val or Val/ (196.24�±118.43 vs. 277.74�±100.24 ug; p=0.03) genotypes. Our data
indicate that SCCHN patients with inherited distinct abilities for CDDP metabolism, associated with GSTTT1 and GSTP1 Ile105Val
polymorphisms, exhibit distinct toxicities to treatment and urinary CDDP excretion.
Biography
Pincinato E C has completed his Doctorate degree from University of Campinas, Brazil. He is Pharmacist, Assistant Professor of Hematology and Clinical Laboratory Coordinator at Mackenzie Presbyterian University.