CC BY-NC-ND 4.0 · Journal of Coloproctology 2021; 41(02): 188-192
DOI: 10.1055/s-0041-1725047
Review Article

Association between UGT1A1*28 Gene Polymorphism and Severe Neutropenia due to Colorectal Cancer Treatment with Irinotecan: Evidence Based on Meta-Analysis

Associação entre o polimorfismo do gene UGT1A1*28 e a neutropenia severa decorrente do tratamento do câncer colorretal com irinotecano: evidências baseadas em meta-análise
1  Biomedicine Course, Universidade Paulista (UNIP), Goiânia, GO, Brazil
,
2  Faculdade de Enfermagem (FEN), Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil
,
3  Programa de Pós-Graduação, Mestrado em Ciências Ambientais e Saúde (MCAS), Pontifícia Universidade Católica de Goiás (PUC Goiás), Goiânia, GO, Brazil
,
4  Tumoral Biology and Oncogenetics Laboratory, Hospital Araújo Jorge, Goiânia, GO, Brazil
,
1  Biomedicine Course, Universidade Paulista (UNIP), Goiânia, GO, Brazil
,
3  Programa de Pós-Graduação, Mestrado em Ciências Ambientais e Saúde (MCAS), Pontifícia Universidade Católica de Goiás (PUC Goiás), Goiânia, GO, Brazil
5  Medicine Course, Escola de Ciências Médicas, Farmacêuticas e Bimomédicas (EMFB), Pontifícia Universidade Católica de Goiás (PUC Goiás), Goiânia, GO, Brazil
› Author Affiliations

Abstract

Objective The present study aimed to evaluate the relationship between UGT1A1*28 gene polymorphism and the prevalence of neutropenia in patients with colorectal cancer treated with irinotecan.

Method Thirteen studies were included. These papers were selected from the Virtual Health Library, Scientific Electronic Library Online, International Health Sciences Literature and PubMed, and their data were collected and evaluated using the BioEstat 5.3 software (BioEstat, Belém, PA, Brazil).

Results Three genotypes were analyzed, namely 6/6 (wild type), 6/7, and 7/7. In total, 2,146 patients were included in the present study; of these, 55.6% (n = 1,193) had 6/6 genotype, 37.3% (n = 801) were heterozygous (6/7), and 7.1% (n = 152) had the 7/7 genotype. A total of 1,672 (77.9%) patients displayed mild neutropenia, whereas 474 (22.1%) had severe neutropenia. When contrasting the 6/7 and 7/7 genotypes with the 6/6 genotype using statistical tests for meta-analysis, patients with the 7 allele, either in homozygosis or heterozygosis, presented higher risk of developing severe neutropenia than patients with the 6/6 genotype (odds ratio = 1.559; 95% confidence interval = 1.163–2.090; p = 0.003).

Conclusion The analysis of the UGT1A1*28 gene polymorphism can aid the choice of treatment for patients with colorectal cancer in personalized medicine, increasing the chances of therapeutic success.

Resumo

Objetivo Avaliar a relação do polimorfismo do gene UGT1A1*28 com a prevalência de neutropenia em pacientes com câncer colorretal submetidos a tratamento com o irinotecano.

Método Foram incluídos 13 estudos sobre o tema proposto, selecionados nas bases de dados da Biblioteca Virtual de Saúde, Scientific Electronic Library Online, International Health Sciences Literature e PubMed. Os dados foram coletados dos artigos científicos selecionados e avaliados com o auxílio do software BioEstat 5.3 (BioEstat, Belém, PA, Brasil).

Resultados Os genótipos analisados foram 6/6 (tipo selvagem), 6/7 e 7/7. Foram incluídos 2.146 pacientes. Destes, 55,6% (n = 1.193) apresentaram genótipo 6/6, 37,3% (n = 801) eram heterozigotos (6/7) e 7,1% (n = 152) tinham o genótipo 7/7. Um total de 1.672 (77,9%) pacientes apresentou neutropenia leve e 474 (22,1%) neutropenia severa. Ao contrastar os genótipos 6/7 e 7/7 com o 6/6, percebeu-se, com a execução dos testes estatísticos de meta-análise, que os pacientes com o alelo 7, em homozigose ou heterozigose, tinham maior risco de desenvolver neutropenia severa que pacientes com o genótipo 6/6 (razão de chances = 1,559; intervalo de confiança de 95% = 1,163–2,090; p = 0,003).

Conclusão A análise do polimorfismo do gene UGT1A1*28 pode auxiliar na escolha do tratamento do paciente com câncer colorretal, no contexto da medicina personalizada, ampliando, assim, as chances de sucesso terapêutico.



Publication History

Received: 21 May 2020

Accepted: 11 August 2020

Publication Date:
30 June 2021 (online)

© 2021. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil