Pharmacogenomics and Personalized Medicine (Dec 2022)
Severe Vincristine-Induced Neuropathic Pain: A Case Report with Pharmacogenetic Analysis and Literature Review
Abstract
Ya-Hui Hu,1 Gui-Zhou Li,1,2 Jia-Yi Long,1,2 Qing-Yan Yang,1,2 Yong Zhang,1 Feng Chen,1 Yong-Ren Wang3 1Department of Pharmacy, Children’s Hospital of Nanjing Medical University, Nanjing, People’s Republic of China; 2School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, People’s Republic of China; 3Department of Hematology and Oncology, Children’s Hospital of Nanjing Medical University, Nanjing, People’s Republic of ChinaCorrespondence: Yong-Ren Wang, Children’s Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, People’s Republic of China, Email [email protected]: Vincristine-induced peripheral neuropathy (VIPN) is a common adverse effect of vincristine (VCR) for which there is no preventative or curative treatment. Here, we report a case of a patient suffering from severe VCR-related neurotoxicity. To explore the possible causes of severe VIPN in this patient, a set of genes involved in VCR metabolism, transport or are related to the cytoskeleton, microtubules, and inherited neurological diseases gene polymorphisms were examined via pharmacogenetic analyses. The genotyping results revealed the presence of a complex pattern of polymorphisms in CYP3A5, ABCC2, SYNE2, BAHD1, NPSR1, MTNR1B, CEP72, miR-4481 and miR-3117. A comprehensive understanding of all the pharmacogenetic risk factors for VIPN may explain the occurrence of severe neurotoxicity in our patient. This case brings to light the potential importance of pharmacogenetic testing in clinical practice. It also exemplifies the importance of developing early-detection strategies to optimize treatment regimens through prior risk stratification while reducing adverse drug reactions and personalizing therapy.Keywords: vincristine, peripheral neuropathy, pharmacogenetics, toxicity, polymorphisms, precision medicine
