Novel approaches for the discovery of pharmacogenetic biomarkers of chemotoxicity in patients with colorectal cancer


Por: Simoes, AR, González, SC, Lopez-Doldan, MD, Duran, G, Fernández-Montes, A, Fernandez, MP, Fernandez, MS, Mata, JG, Paez, D, Riera, P, Guino, E, Lopez-Fernandez, L, de Santiago, BG, Aspiroz, EL, Rojas, A, Castells, A, Castellvi-Bel, S, Ponte, CR, Vymetalkova, V, Carracedo, A, Fernandez-Rozadilla, C

Publicada: 1 nov 2025 Ahead of Print: 1 jul 2025
Resumen:
Background and Purpose Chemotherapeutic treatment for colorectal cancer (colorectal cancer) allows for increased patient overall survival. However, current therapeutic regimens are often associated with the development of adverse drug reactions, which represent a morbidity, mortality and economic issue. We propose to identify novel germline markers that allow us to predict adverse drug reactions development after colorectal cancer chemotherapy. Experimental Approach For that purpose, we selected 163 colorectal cancer patients with severe adverse drug reactions (CTCAE grades 3-4) and 52 controls and applied whole-exome sequencing (WES) to discover novel germline toxicity variants. Key Results We found 13 cases carrying actionable dihydropyrimidine dehydrogenase gene (DPYD) variants and a novel, potentially pathogenic DPYD variant - c.2071G > T, p.(V691L), rs202212118. Moreover, we found 30 novel rare, high-impact variants in 14 reported genes. We also identified seven patients carrying more than one variant in the same gene or pathway, with one patient hinting at a potential digenic inheritance. Using an exome-wide approach, we discovered and independently validated three novel candidate toxicity genes (ALDH9A1, FAM83A and EPX). Gene-based analyses also provided 14 genes significantly associated with neuropathy, skin toxicity and cardiotoxicity. Conclusions and Implications Overall, the present work has utilised state-of-the-art approaches to uncover several novel candidate toxicity variants/genes.

Filiaciones:
Simoes, AR:
 Inst Invest Sanitaria Santiago IDIS, Santiago De Compostela, Spain

González, SC:
 Inst Invest Sanitaria Santiago IDIS, Santiago De Compostela, Spain

Lopez-Doldan, MD:
 Complexo Hosp Univ Ourense, Oncol Pharm Unit, Orense, Spain

Duran, G:
 Univ Hosp Santiago De Compostela Pharm Serv, Pharm Dept, Santiago De Compostela, Spain

Fernández-Montes, A:
 Complexo Hosp Univ Ourense, Med Oncol Unit, Orense, Spain

Fernandez, MP:
 Complexo Hosp Univ Ourense, Oncol Pharm Unit, Orense, Spain

Fernandez, MS:
 Complexo Hosp Univ Ourense, Med Oncol Unit, Orense, Spain

Mata, JG:
 Complexo Hosp Univ Ourense, Med Oncol Unit, Orense, Spain

Paez, D:
 Hosp Santa Creu & Sant Pau, Med Oncol Dept, Barcelona, Spain

 Inst Invest Biomed St Pau, Translat Med Oncol Lab, Barcelona, Spain

 Hosp Santa Creu & Sant Pau, Pharm Dept, Barcelona, Spain

 Inst Salud Carlos III, Ctr Biomed Res Network Rare Dis CIBERER, Madrid, Spain

Riera, P:
 Inst Invest Biomed St Pau, Translat Med Oncol Lab, Barcelona, Spain

Guino, E:
 Catalan Inst Oncol, Oncol Data Analyt Program, Barcelona, Spain

 Colorectal Canc Grp, Bellvitge Inst Biomed Res, Barcelona, Spain

 Mol Mech & Expt Therapy Oncol ONCOBELL Program, Barcelona, Spain

 Inst Salud Carlos III, Biomed Res Ctr Network Epidemiol & Publ Hlth, Consortium CIBERESP, Madrid, Spain

Lopez-Fernandez, L:
 Hosp Gen Univ Gregorio Maranon, Serv Farm, Madrid, Spain

 Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain

de Santiago, BG:
 Infanta Sofia Univ Hosp, Pharm Serv, Madrid, Spain

Aspiroz, EL:
 Infanta Sofia Univ Hosp, Pharm Serv, Madrid, Spain

 Univ Europea Madrid, Fac Med Hlth & Sports, Madrid, Spain

Rojas, A:
 Tecnol Monterrey, Sch Med & Hlth Sci, Monterrey, Mexico

Castells, A:
 Hosp Clin Barcelona, Gastroenterol Unit, Barcelona, Spain

 Inst Invest Biomed August Pi i Sunyer IDIBAPS, Gastroenterol Dept, Barcelona, Spain

 Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain

Castellvi-Bel, S:
 Hosp Clin Barcelona, Gastroenterol Unit, Barcelona, Spain

 Inst Invest Biomed August Pi i Sunyer IDIBAPS, Gastroenterol Dept, Barcelona, Spain

 Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain

 Hosp Clin Barcelona, Gastroenterol Dept, Barcelona, Spain

Ponte, CR:
 Inst Invest Sanitaria Santiago IDIS, Santiago De Compostela, Spain

 Galician Publ Fdn Genom Med FPGMX, Santiago De Compostela, Spain

 Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Raras CIBERER, Madrid, Spain

Vymetalkova, V:
 Charles Univ Prague, Czech Acad Sci, Inst Expt Med, Dept Mol Biol Canc, Prague, Czech Republic

Carracedo, A:
 Inst Invest Sanitaria Santiago IDIS, Santiago De Compostela, Spain

 Galician Publ Fdn Genom Med FPGMX, Santiago De Compostela, Spain

 Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Raras CIBERER, Madrid, Spain

 Univ Santiago De Compostela, Genom Med Grp, Santiago De Compostela, Spain

Fernandez-Rozadilla, C:
 Inst Invest Sanitaria Santiago IDIS, Santiago De Compostela, Spain

 Galician Publ Fdn Genom Med FPGMX, Santiago De Compostela, Spain

 Univ Santiago De Compostela, Genom Med Grp, Santiago De Compostela, Spain
ISSN: 00071188





BRITISH JOURNAL OF PHARMACOLOGY
Editorial
WILEY, 111 RIVER ST, HOBOKEN 07030-5774, NJ USA, GB
Tipo de documento: Article
Volumen: 182 Número: 21
Páginas: 5340-5354
WOS Id: 001523606300001
ID de PubMed: 40624839
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