Doxorubicin pathways: pharmacodynamics and adverse effects

CF Thorn, C Oshiro, S Marsh… - Pharmacogenetics …, 2011 - journals.lww.com
Pharmacogenetics and genomics, 2011journals.lww.com
The goal of this study is to give a brief background on the literature supporting the
PharmGKB pathway about doxorubicin action, and provides a summary of this active area of
research. The reader is referred to recent in-depth reviews [1–4] for more detailed
discussion of this important and complex pathway. Doxorubicin is an anthracyline drug first
extracted from Streptomyces peucetius var. caesius in the 1970's and routinely used in the
treatment of several cancers including breast, lung, gastric, ovarian, thyroid, non-Hodgkin's …
The goal of this study is to give a brief background on the literature supporting the PharmGKB pathway about doxorubicin action, and provides a summary of this active area of research. The reader is referred to recent in-depth reviews [1–4] for more detailed discussion of this important and complex pathway. Doxorubicin is an anthracyline drug first extracted from Streptomyces peucetius var. caesius in the 1970’s and routinely used in the treatment of several cancers including breast, lung, gastric, ovarian, thyroid, non-Hodgkin’s and Hodgkin’s lymphoma, multiple myeloma, sarcoma, and pediatric cancers [5–7]. A major limitation for the use of doxorubicin is cardiotoxicity, with the total cumulative dose being the only criteria currently used to predict the toxicity [4, 8]. As there is evidence that the mechanisms of anticancer action and of cardiotoxicity occur through different pathways there is hope for the development of anthracycline drugs with equal efficacy but reduced toxicity [4]. Knowledge of the pharmacogenomics of these pathways may eventually allow for future selection of patients more likely to achieve efficacy at lower doses or able to withstand higher doses with lesser toxicity. We present here graphical representations of the candidate genes for the pharmacogenomics of doxorubicin action in a stylized cancer cell (Fig. 1) and toxicity in cardiomyocytes (Fig. 2), and a table describing the key variants examined so far.
Lippincott Williams & Wilkins