Potential association of SULT2A1 and ABCG2 variant alleles with increased risk for palbociclib toxicity

Pharmacogenomics. 2024;25(8-9):367-375. doi: 10.1080/14622416.2024.2380240. Epub 2024 Aug 2.

Abstract

Aim: This study evaluated associations between CYP3A4*22 and variants in other pharmacogenes (CYP3A5, SULT2A1, ABCB1, ABCG2, ERCC1) and the risk for palbociclib-associated toxicities.Materials & methods: Two hundred cancer patients who received standard-of-care palbociclib were genotyped and associations with toxicity were evaluated retrospectively.Results: No significant associations were found for CYP3A4*22, CYP3A5*3, ABCB1_rs1045642, ABCG2_rs2231142, ERCC1_rs3212986 and ERCC1_rs11615. Homozygous variant carriers of SULT2A1_rs182420 had higher incidence of dose modifications due to palbociclib toxicity (odds ratio [OR]: 4.334, 95% CI: 1.057-17.767, p = 0.042). ABCG2_rs2231137 variant carriers had borderline higher incidence of grade 3-4 neutropenia (OR: 4.14, 95% CI: 0.99-17.37, p = 0.052).Conclusion: Once validated, SULT2A1 and ABCG2 variants may be useful to individualize palbociclib dosing to minimize toxicities and improve treatment outcomes.

Keywords: Breast cancer; CDK4/6 inhibitors; palbociclib; pharmacogenetics; toxicity.

Plain language summary

[Box: see text].

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily G, Member 2* / genetics
  • Adult
  • Aged
  • Aged, 80 and over
  • Alleles*
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Arylsulfotransferase / genetics
  • Female
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Proteins* / genetics
  • Neoplasms / drug therapy
  • Neoplasms / genetics
  • Piperazines* / adverse effects
  • Piperazines* / therapeutic use
  • Polymorphism, Single Nucleotide / genetics
  • Pyridines* / adverse effects
  • Retrospective Studies

Substances

  • ATP Binding Cassette Transporter, Subfamily G, Member 2
  • Piperazines
  • ABCG2 protein, human
  • palbociclib
  • Pyridines
  • Neoplasm Proteins
  • Antineoplastic Agents
  • Arylsulfotransferase