Clinical Observation of Gene Polymorphism of Olanzapine or Aprepitant in Prevention of CINV

Abstract

Yilan Jin,1,* Gaowa Jin,2,* Jun Zhao,2 Caihong Jiang,2 Lanzhen Zhao,2 Ying Jiang,2 Feng Chen,2 Hui Li,2 Wenjuan Wang,2 Yungaowa Wu,2 Guang Liu,2 Xiaorong Li,2 Min Gu,2 Xiaomei Li,3 Quanfu Li2 1Ordos Clinical College, Inner Mongolia Medical University, Ordos, 017000, People’s Republic of China; 2Department of Medical Oncology, Ordos Central Hospital, Ordos, 017000, People’s Republic of China; 3Department of Medical Oncology, The General Hospital of the People’s Liberation Army, Beijing, 100853, People’s Republic of China*These authors contributed equally to this workCorrespondence: Quanfu LiDepartment of Medical Oncology, Ordos Central Hospital, Ordos, 017000, People’s Republic of ChinaTel [phone]Fax [phone]Email [email protected] LiDepartment of Medical Oncology, The General Hospital of the People’s Liberation Army, Beijing, 100853, People’s Republic of ChinaTel [phone]Email [email protected]: The present study aims to investigate the correlation between the gene polymorphisms of the multidrug resistance protein 1 (ABCB1), the intron region of transcriptional factor (GTF2E1) and catechol-O-methyltransferase (COMT), dopamine receptor (DRD2), and the control of chemotherapy-induced nausea and vomiting (CINV) by olanzapine or aprepitant in a Chinese population under a fractionated cisplatin dosing pattern.Methods: Antiemetic treatment with 5 mg of olanzapine or aprepitant triplet therapy was conducted in 210 patients with malignancies receiving cisplatin multi-day chemotherapy. The general data on the patients were collected with the evaluation of the rate of complete protection (TP), complete remission (CR), complete control (TC), and time to first vomiting, the functional living index-emesis (FLIE) scale, and side effects in the acute and delayed phases. The DNA mass spectrometry detected the gene polymorphisms of ABCB1, GTF2E1, COMT, and DRD2, and the correlation with TP was analyzed.Results: 1) There were no statistically significant differences in the TP, CR, TC, time of first vomiting, and FLIE index at different phases between the 5mg of olanzapine group and the aprepitant group (P > 0.05). 2) The main side effect in the olanzapine group was drowsiness (P = 0.00), and in the aprepitant group was constipation (P = 0.02). 3) The distributions of each genotype were in the Hardy–Weinberg (H–W) equilibrium. Univariate analysis showed that in the olanzapine group, delayed-phase TP was correlated with the ABCB1 rs1045642 non-TT (P = 0.01) genotype.Conclusion: The present study revealed that females and the rs1045642TT genotype were independent risk factors for delayed-phase CINV in the northern Chinese population, which provided a scientific basis for subsequent CINV-related analysis of high-risk factors in Chinese patients.Keywords: chemotherapy-induced nausea and vomiting, cisplatin, multi-day chemotherapy, gene polymorphism

Keywords

• chemotherapy-induced nausea and vomiting； cisplatin； multi-day chemotherapy； gene polymorphism