Erythropoietin promoter polymorphism is associated with treatment efficacy and severe hematologic toxicity for platinum-based chemotherapy

Abstract

ABSTRACT Background: Erythropoietin (EPO) plays a substantial role in cancer development and probably affects clinical outcomes. A functional polymorphism (rs1617640, G > T) in the promoter region of the EPO increases protein expression. This study investigated the association of EPO rs1617640 with treatment efficacy and severe toxicity in non-small cell lung cancer (NSCLC) patients undergoing platinum-based regimens. Methods: 437 Chinese NSCLC patients treated with platinum-based chemotherapy were recruited. Association between EPO rs1617640 and clinical outcomes was calculated by multivariable logistic regression. Results: The TT genotype of EPO rs1617640 was significantly correlated with a higher response rate to platinum-based treatment than the other genotypes (OR, 0.507; 95% CI: 0.305–0.842; P = 0.009), particularly in elderly patients (>55 years), male gender, smokers, IV stage, cisplatin-based chemotherapies, and platinum-gemcitabine regimen subgroups. As for toxicity, EPO rs1617640 TT genotype demonstrated poorer tolerance to grade 3–4 hematologic toxicity (OR, 1.783; 95% CI: 1.098–2.898; P = 0.019), particularly in subgroups of elderly patients (>55 years), male gender, smokers, IIIA+IIIB stage, and cisplatin-based chemotherapies. Conclusion: Our results demonstrated the role of EPO rs1617640 as a possible predictive marker of treatment efficacy and severe toxicity for platinum-based chemotherapy.