Abstract

BackgroundChemotherapy toxicity is a serious problem from which non-small cell lung cancer (NSCLC) patients suffer. The mismatch repair (MMR) system is associated with platinum-based chemotherapy toxicity in NSCLC patients. In this study, we aimed to investigate the relationship between genetic polymorphisms in the MMR pathway and platinum-based chemotherapy toxicity in NSCLC patients.MethodsA total of 220 Chinese lung cancer patients who received at least two cycles of platinum-based chemotherapy were recruited for this study. Toxicity was evaluated in each patient after two cycles of chemotherapy. A total of 44 single nucleotide polymorphisms were selected to investigate their associations with platinum-based chemotherapy toxicity.ResultsMutS homolog 2 (MSH2) rs6544991 [odds ratio (OR) 2.98, 95% confidence interval (CI) 1.20–7.40, P = 0.019] was associated with gastrointestinal toxicity in the dominant model; MSH3 rs6151627 (OR 2.38, 95% CI 1.23–4.60, P = 0.010), rs6151670 (OR 2.05, 95% CI 1.07–3.93, P = 0.031), and rs7709909 (OR 2.38, 95% CI 1.23–4.64, P = 0.010) were associated with hematologic toxicity in the dominant model. Additionally, MSH5 rs805304 was significantly associated with overall toxicity (OR 2.21, 95% CI 1.19–4.09, P = 0.012), and MSH5 rs707939 was significantly associated with both overall toxicity (OR 0.42, 95% CI 0.23–0.76, P = 0.004) and gastrointestinal toxicity (OR 0.44, 95% CI 0.20–0.96, P = 0.038) in the dominant model.ConclusionGenetic polymorphisms in the MMR pathway are potential clinical markers for predicting chemotherapy toxicity in NSCLC patients.

Highlights

  • Chemotherapy toxicity is a serious problem from which non-small cell lung cancer (NSCLC) patients suffer

  • To investigate the relationship between mismatch repair (MMR) pathway genetic polymorphisms and platinum-induced toxicity, we evaluated 6 MMR genes (MLH1, MutS homolog 2 (MSH2), MSH3, MSH4, MSH5, and MSH6) in Chinese NSCLC patients

  • A total of 44 single nucleotide polymorphisms (SNPs) were genotyped in these patients, and 37 of them were in Hardy–Weinberg equilibrium (HWE) (P > 0.05) and exhibited an minor allele frequency (MAF) ≥ 5%

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Summary

Introduction

Chemotherapy toxicity is a serious problem from which non-small cell lung cancer (NSCLC) patients suffer. The mismatch repair (MMR) system is associated with platinum-based chemotherapy toxicity in NSCLC patients. We aimed to investigate the relationship between genetic polymorphisms in the MMR pathway and platinum-based chemotherapy toxicity in NSCLC patients. MutL homolog 1 (MLH1) dimerizes with postmeiotic segregation increased 1 (PMS1), PMS2, or MLH3 to form the MLH1/PMS2 (MutLα), MLH1/PMS1 (MutLβ), or MLH1/MLH3 (MutLγ) heterodimer and MutS homolog 2 (MSH2) dimerizes with MSH6 or MSH3 to form the MSH2/MSH6 (MutSα) or MSH2/MSH3 (MutSβ) heterodimer so as to bind the DNA helix and recognize DNA mismatches. Together with the abovementioned MutL complexes, the MutSα complex guides the repair of single-base and small-loop mismatches, whereas the MutSβ complex guides the repair of small- to large-loop mismatches [16,17,18,19]. MutSα and MutLα are key proteins in the MMR system and are responsible for mismatch detection and subsequent repair event coordination [20, 21]

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