| Purpose: Compare gene polymorphism in patients with renal cell carcinomareceiving Sunitinib for the therapeutic efficacy and side effects related to the gravity ofthe situation，discussion on gene detection of Sunitinib for the treatment of renal cellcarcinoma and the severity of the side effects of predictive value.Method: It collected cases from October,2012to April,2014which are tested aslate period CCRCC and have metastasized with ratable focus. There are22patients withgood performance status who never have other antineoplastic drugs before takingsunitinib and have had gene tests. According to gene testing result, people withrs307826(gene VEGFR3)SNP homozygote A/A and heterozygote A/G were dividedinto two parts which are18and4.The are examined and were counted according to thecriterion of curative effect of solid tumor (V1.1) after taking sunitinib. People withrs776746(gene CYP3A5) SNP homozygote G/G and heterozygote G/A were dividedinto two parts which are9and13.They were examined the side-effect after takingsunitinib according to international adverse drug reaction.Result:1.curative effect:(1)Median treatment time lasted10(2-16) months for18people in VEGFR3rs307826SNP A/A group who could be evaluated for efficacy.1patient gotCR(complete response),9for PR(partial response),5for SD(stable disease),3forPD(progressive disease),1of them died of sarcoma. Objective response rate was55.6%.Disease control rate was83.3%. The median follow-up time was11(2-17) months. Due to the reason that follow-up were not long, less than half patients were in PD or died.PFS(progressive free survival) and OS(overall survival) were hard to evaluate.(2)Median treatment time lasted9(5-14) months for4patients in group ofVEGFR3rs307826SNP heterozygote A/G which can be evaluated for efficacy. Thereis no CR,1for PR, no SD,3for PD. Objective response rate was25%and diseasecontrol rate is50%. PFS is8months. Follow-up time is not long with no people dying.OS was hard to be evaluated.(3) Two groups of patients didn’t have the difference of the survival rate of diseaseprogression, the log-rank test had statistical significance (P=0.044).2. Adverse Reaction:（1）The number of patients whose homozygous CYP3A5rs776746SNP loci withG/G is nine,adverse reactions include:Lack of power, the brotherhood of syndrome,4cases of hypertension, leukopenia, skin yellow dye, diarrhea, thrombocytopenia, andneutropenia. All adverse reactions are level1, without level2and above adversereactions, without adverse reactions associated with reducing.（2）The number of patients whose heterozygous CYP3A5rs776746SNP loci withG/A is thirteen,adverse reactions include:Lack of power, the brotherhood of syndrome,hypertension, leukopenia, skin yellow dye, diarrhea, thrombocytopenia, andneutropenia, hair color change, oral ulcers, skin rash.2levels of adverse reactionsincluding1case of rash,1case of oral ulcer,1case of leukopenia and1case ofneutropenia,three levels of adverse reactions including2case of neutropenia, the restof the adverse reactions are grade1, without above level3adverse reactions，in2cases(15.4%) because of white blood cells reduce drug reducing serious adverse reactions.（3）Compared the incidence of adverse reactions of two group patients whoselevel of adverse reactions are grade2and above grade2, checked by Fisher’s exactprobability method:bilateral inspection was statistically significant (P=0.046),unilateral test has statistical significance (P=0.023).Conclusion: Kidney cancer genetic testing results for predicting sunitinib for thecurative effect of treatment of advanced kidney cancer susceptibility and the extent of the adverse reactions has certain reference value.Sunitinib for the homozygous genotypeof A/A kidney cancer treatment effect is better than the heterozygote genotypes of A/Gkidney cancer treatment effect.The incidence of adverse reactions of the G/Ghomozygous genotype kidney cancer patients receiving sunitinib treatment is lowerthan heterozygote genotypes of G/A group. |
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