Methotrexate in Pediatric Osteosarcoma: Response and Toxicity in Relation to Genetic Polymorphisms and Dihydrofolate Reductase and Reduced Folate Carrier 1 Expression - 08/08/11
, Marta Zalacaín, PhD a, Lucía Marrodán, BSc a, Mikel San-Julián, MD, PhD b, Luis Sierrasesúmaga, MD, PhD a
Reprint requests: Ana Patiño-García, PhD, Laboratory of Pediatrics, University of Navarra/University Clinic, Irunlarrea SN, Los Castaños Building, 31080 Pamplona, SpainRésumé |
Objective |
To determine the influence of the genotype and the level of expression of different enzymes involved in folate metabolism on the response to and toxicity of high-dose methotrexate treatment in pediatric osteosarcomas.
Study design |
DHFR and Reduced folate carrier 1 (RFC1) semiquantitative expression was analyzed in 34 primary and metastatic osteosarcoma tissues by real-time polymerase chain reaction. The following polymorphisms were also analyzed in peripheral blood from 96 children with osteosarcoma and 110 control subjects: C677T, A1298C (MTHFR), G80A (RFC1), A2756G (MTR), C1420T (SHMT), the 28bp-repeat polymorphism, and 1494del6 of the TYMS gene. Treatment toxicity was scored after each cycle according to criteria from the World Health Organization.
Results |
DHFR and RFC1 expression was lower in initial osteosarcoma biopsy specimens than in metastases (P = .024 and P = .041, respectively). RFC1 expression was moderately decreased in samples with poor histologic response to preoperative treatment (P = .053). Patients with osteosarcoma with G3/G4 hematologic toxicity were more frequently TT than CT/CC for C677T/MTHFR (P = .023) and GG for A2756G/MTR (P = .048 and P = .057 for gastrointestinal and hematologic toxicity, respectively).
Conclusions |
The role of C677T/MTHFR and A2756G/MTR on chemotherapy-induced toxicity should be further investigated in pediatric osteosarcomas receiving high-dose methotrexate. Altered expression of DHFR and RFC1 is a feasible mechanism by which osteosarcoma cells become resistant to methotrexate.
Le texte complet de cet article est disponible en PDF.Abbreviations : DHFR, GAPDH, HD-MTX, MTHFR, MTR, MTX, OR, RFC1, SHMT, TYMS
Plan
| This work was partially supported by a grant from the Department of Education and Culture of the Gobierno de Navarra. The authors declare no conflicts of interest. |
Vol 154 - N° 5
P. 688-693 - mai 2009 Retour au numéro
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