Association Of RAD23B Gene Polymorphisms With The Efficacy Of Platinum Based Two Drug Combination Chemotherapy And Blood Toxicity Of Chemotherapy In Non Small Cell Lung Cancer

Objective:The aim of this study was to study the relationship between the RAD23B gene polymorphism and the short-term efficacy and toxicity of platinum based two drug combination chemotherapy in patients with non small cell lung cancer(NSCLC).Methods: Blood samples were collected from 150 patients with non small cell lung cancer at the Guangxi Medical University Affiliated Cancer Hospital during September -2005 to September -2009 . In this study, we analyzed the relationship between the polymorphism of RAD23B gene 14 SNP site and the recent curative effect of the platinum group and the blood toxicity of the chemotherapy. and then carries on the genotyping by iMLDR technology.Patients in the group were given access to medical records, records of gender,age, ECOG score, smoking, TNM stage, treatment regimen, blood toxicity,recent curative effect, etc.. Using SPSS 19.0 software to analyze the short-term efficacy and toxicity of RAD23B in the treatment of all kinds of point based and platinum.Resualt: 1,Association of RAD23B gene polymorphism and platinum based two drug combination in the recent efficacy: rs10759225? rs1323809,SNP RAD23B and platinum class recent efficacy related, There were significant differences in the efficacy of platinum group in the patients with GG rsl0759225 genotype and G/A+A/A genotype NSCLC (P<0.05 ) . Compared with the G/A+A/A genotype patients, the short-term effective rates of the patients with type GG were lower than those of the patients w:ith type OR=0.434(0.19-0.994 95%CI, P=0.048). Patients with rsl323809 C/C genotype and the C/T+T/T genotype NSCLC patients had statistically significant difference (P <0.05), and the short term effective rate of the patients with C/T+T/T genotypewas lower than that of the patients with type C/C OR=0.434 (0.19-0.994 95%CI,P=0.048).2. The relationship between RAD23B gene polymorphism and the white blood cell toxicity of chemotherapy : Carrying C/T and C/T+T/T genotype of NSCLC patients and patients with C/C genotype appeared white blood cell toxicity has significant difference (P < 0.05), Patients with C/T+T/T genotype were less likely to have a white blood cell reduction compared with patients who were treated with a platinum based combination chemotherapy based on the platinum group, compared with the C/C genotype OR=0.036 ( 95% CI 0.138-0.94 P=0.037). Carry rs10521083, rs10759222, rs10759225, rs1323809,rs1805332, rs1805334, rs1805335, rs2147072, rs4278207, rs7035611,rs7041497, rs942292 mutation homozygous genotype patients and carry homozygous wild-type patients ?-? degree white blood cell toxicity have a statistically significant difference (p < 0.05). The risk of ?-? degree of white blood cell toxicity after chemotherapy in patients with rs10759225A/A genotype was 8.582 times (OR=8.582, 1.112-66.21, 95%CI, P=0.039) in patients with G/G. The risk of rs1323809 degree of white blood cell toxicity after chemotherapy in patients with T/T ?-? genotype was 8.582 times that of C/C patients (OR=8.582,1.112-66.21 95%CI, P=0.039).3. The relationship between the RAD23B gene polymorphism and the toxicity of neutrophils in chemotherapy: There was a statistical difference (P <0.05) in the probability of ?-? degree neutrophil toxicity after chemotherapy in patients with rs10759225, rs1323809 mutation genotype and in patients with wild-type homozygous. The carrying rs10759225G/A gene type chemotherapy appeared probability of ?-? degree neutropenia in patients with G/G genotype 5.551 times (OR =5.551, 95% CI 1.716-17.962, P-0.004). Carry rs10759225 A/A genotype in patients with chemotherapy ?-? degree neutropenia is 11.315 times in patients with G/G genotype (or = 11.315, 95%CI 1.191-107.512, P = 0.035). The probability of chemotherapy neutrophil toxicity rs10759225G/A+A/A genotype was 6.096 times more than that of the patients with G/G type ( OR= 6.096,95%CI 1.945-19.106, P=0.002 ) . The risk of ?-? neutrophil toxicity after chemotherapy in patients with rs1323809C/T genotype was 5.551 times that of C/C patients (OR= 5.551, 1.716-17.962,95%CI P=0.004,); The risk of ?-? neutrophil toxicity after chemotherapy in patients with rs1323809T T/ genotype was 11.315 times that of C/C patients(OR= 11.315, 1.191-107.512, 95%CI P=0.035). The risk of ?-? T neutrophil toxicity after chemotherapy in patients with C/ T +T/ genotype was 6.096 times that of C/C genotype patients (OR= 6.096, 95%CI, 1.945-19.106 P=0.002,rs1323809). The risk of ?-? neutrophil toxicity after chemotherapy in patients with rs1323809 C/ T +T/ Tgenotype was 6.096 times that of C/C genotype patients (OR= 6.096, 95%CI, 1.945-19.106 P=0.002,). SNP polymorphism and NSCLC were not found in patients with platinum based two drug combination chemotherapy with a statistically significant difference in neutrophil toxicity(P>0.05).4. Relationship between RAD23B gene polymorphism and platelet toxicity in chemotherapy: There was a statistically significant difference in the probability of thrombocytopenia (P < 0.05) in NSCLC patients with rs7023656 C/T, C/T+T/T genotype and C/C genotype NSCLCL patients after chemotherapy.The probability of thrombocytopenia after chemotherapy in patients with C/T genotype was 3.117 times as much as that in patients with C/C genotype(1.224-7.939 P=0.017 OR=3.117,95%CI) .The incidence of thrombocytopenia in patients carrying the C/T+T/T genotype was 2.629 times that of the C/C genotype (1.063-6.498 P=0.036 OR=3.117,95%CI) .did not find the above SNP polymorphism and NSCLC patients with chemotherapy appear ?-? degree of platelet toxicity exist statistical difference P > 0.05.5. The relationship between RAD23B gene polymorphism and anemia after chemotherapy: Did not find the above SNP polymorphism and NSCLC patients with anemia in the presence of statistical difference P > 0.05 .Did not find the above SNP polymorphism and NSCLC patients with chemotherapy appear ?-? degrees anemia in the presence of statistical difference P > 0.05.Conclusion:1, rs10759225 rs1323809, RAD23B and NSCLC containing platinum combined chemotherapy efficacy.2, rs7023656 NSCLC and RAD23B platinum containing platinum combination chemotherapy toxicity related.3, rs10759225 rs1323809, RAD23B and NSCLC containing platinum combination chemotherapy for severe neutrophil toxicity related.4, rs7023656 NSCLC and RAD23B containing platinum combined chemotherapy platelet toxicity related.5, did not find the polymorphism of RAD23B gene and NSCLC combined with platinum chemotherapy related anemia.