Population-based differences in treatment outcome following anticancer drug therapies.
Population-based differences in toxicity and clinical outcome following treatment with anticancer drugs have an important effect on oncology practice and drug development. These differences arise from complex interactions between biological and environmental factors, which include genetic diversity affecting drug metabolism and the expression of drug targets, variations in tumour biology and host physiology, socioeconomic disparities, and regional preferences in treatment standards. Some well-known examples include the high prevalence of activating epidermal growth factor receptor (EGFR) mutations in pulmonary adenocarcinoma among northeast (China, Japan, Korea) and parts of southeast Asia (excluding India) non-smokers, which predict sensitivity to EGFR kinase inhibitors, and the sharp contrast between Japan and the west in the management and survival outcome of gastric cancer. This review is a critical overview of population-based differences in the four most prevalent cancers in the world: lung, breast, colorectal, and stomach cancer. Particular attention is given to the clinical relevance of such knowledge in terms of the individualisation of drug therapy and in the design of clinical trials.
State Key Laboratory in Oncology in South China, Sir Y K Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute, and Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong.
Brigette By
BB
Ma
Edwin P
EP
Hui
Tony Sk
TS
Mok
D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000453:epidemiology; D004777:Environment; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000188:drug therapy* / Q000453:epidemiology*; D018579:Patient Selection; D010597:Pharmacogenetics; D057285:Precision Medicine; D044469:Racial Groups; D018570:Risk Assessment; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000453:epidemiology; D016896:Treatment Outcome
D000970:Antineoplastic Agents