Polimorfismos genéticos asociados a toxicidad en el tratamiento con 5-fluorouracilo en pacientes con cáncer colorrectal

Abstract

Introduction: Colorectal cancer is the most common malignancy of the digestive tract. The treatment is based basically on administering antitumor medications, like 5-fluorouracil (5-FU), which belongs to the antimetabolites, antineoplastic agents. However, it has been shown that there is toxicity related to genetic polymorphism in patients treated with 5-FU, including gastrointestinal symptoms, myelosuppression, and neurotoxicity. The genetic variations of four genes have been studied, including ABCB1, DPYD, MTHFR, and TYMS. Methodology: Bibliographic review based on digital articles, starting with the research of information about 5-fluorouracil as treatment of patients with colorectal cancer, its adverse reactions, polymorphisms, and toxicity. The database used is PubMed, ScienceDirect, and Scielo, published within the last ten years. It included scientific articles and studies on patients older than 18. Publications in Spanish and English as well as full-text articles. Additionally, the polymorphisms were analyzed in the NCBI (National Center for Biotechnology Information) database, from which the allelic frequencies at the global and Latin American levels were obtained. Results: A total of 11 articles were reviewed, from where we obtained data about polymorphism that developed in patients with colorectal cancer who receive treatment with 5-fluorouracil. The analyzed genes are ABCB1, DPYD, MTHFR, and TYMS. It was established that the polymorphisms trigger toxicity that manifests in different forms: diarrhea, stomatitis, mucositis, and neutropenia.