title: Pretreatment selection of regimen according to genetic analysis improves the efficacy of chemotherapy in the first line treatment of metastatic colorectal cancer.
abstract: OBJECTIVE
  Metastatic colon cancer patients are treated with the chemotherapy regimens, FOLFOX and FOLFIRI, in either order. So far, we cannot predict the response of chemotherapeutic agent, so it is necessary to find which regimen is adequate before starting chemotherapy.
  
  
  METHODS
  Enrolled patients are randomized into either conventional treatment or planned treatment preceded by pretreatment genetic analysis. Blood samples of patients in planned treatment group (N = 53) were analyzed for the genetic polymorphism before selection of chemotherapeutic agents. Target genes were XPD-751, GSTP-1-105, XRCC1-399 for oxaliplatin, UGT1A1 for irinotecan. The response was measured by computed tomographic scan after completion of three cycles of chemotherapy.
  
  
  RESULTS
  Overall response rate was significantly higher in planned group (67.9% vs. 46.3%, P = 0.020). In FOLFOX group, response rate was significantly improved in the planned patients(77.1% vs. 50%, P = 0.018). In FOLFIRI group, the difference didn't reach statistical significance (50% vs. 42.5%, P = 0.776).
  
  
  CONCLUSIONS
  We found significantly improved response rates in the chemotherapy of metastatic colon cancer by pretreatment genetic analysis, especially in FOLFOX group.
authors: Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
authors: Do Yoon
authors: DY
authors: Kim
authors: Tae Yoon
authors: TY
authors: Paek
authors: Seung Yeop
authors: SY
authors: Oh
authors: Young Bae
authors: YB
authors: Kim
authors: Je Hee
authors: JH
authors: Lee
authors: Mi Young
authors: MY
authors: Lee
authors: Zi Sun
authors: ZS
authors: Choi
authors: Kwang Wook
authors: KW
authors: Suh
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000235:genetics*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000235:genetics* / Q000473:pathology; D004268:DNA-Binding Proteins / Q000235:genetics; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D015972:Gene Expression Regulation, Neoplastic; D014453:Glucuronosyltransferase / Q000235:genetics; D051549:Glutathione S-Transferase pi / Q000235:genetics; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000379:methods*; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D020641:Polymorphism, Single Nucleotide; D056910:Republic of Korea; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D000076105:X-ray Repair Cross Complementing Protein 1; D051759:Xeroderma Pigmentosum Group D Protein / Q000235:genetics; D000099148:UGT1A1 Enzyme
chemical_list: D014408:Biomarkers, Tumor; D002166:Camptothecin; D004268:DNA-Binding Proteins; D005472:Fluorouracil; D014453:Glucuronosyltransferase; D051549:Glutathione S-Transferase pi; D002955:Leucovorin; D009944:Organoplatinum Compounds; D000076105:X-ray Repair Cross Complementing Protein 1; D051759:Xeroderma Pigmentosum Group D Protein; D000099148:UGT1A1 Enzyme; C000619371:XRCC1 protein, human; C496556:GSTP1 protein, human; C497292:ERCC2 protein, human
keywords: genomic polymorphisms; metastatic colon cancer; pretreatment genetic analysis