VEGF-A polymorphisms predict progression-free survival among advanced castration-resistant prostate cancer patients treated with metronomic cyclophosphamide

VEGF-A 多态性可预测接受节拍式环磷酰胺治疗的晚期去势抵抗性前列腺癌患者的无进展生存期

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作者:P Orlandi, A Fontana, A Fioravanti, T Di Desidero, L Galli, L Derosa, B Canu, R Marconcini, E Biasco, A Solini, G Francia, R Danesi, A Falcone, G Bocci

Background

No data are available on the pharmacogenetics of metronomic chemotherapy in prostate cancer. The

Conclusion

The -634CC genotype is significantly associated with a shorter PFS in patients treated with a metronomic CTX schedule.

Methods

Forty-three patients were enrolled, and genomic DNA was extracted. VEGF-A gene SNPs (-2578A/C, -634C/G, +936C/T) were analysed using TaqMan PCR assays. Hardy-Weinberg equilibrium was tested for each SNP, and genetic effects were evaluated by Fisher's exact test. PFS and OS were analysed with GraphPad Prism software, using the product limit method of Kaplan and Meier, and comparing survival curves using both the log-rank test and the Gehan-Wilcoxon test. We used Bonferroni correction to account for multiple testing, and a two-tailed P-value of <0.017 was considered statistically significant.

Results

Overall, 20 patients (46%) experienced a reduction in PSA levels from baseline and, among them, 14 (32%) showed a confirmed PSA ≥50% decrease. In non-responders, the -2578CC genotype was more frequent (18.60% vs 2.33% in responders; P=0.0212) whereas the -634CC genotype frequency was 22.73% vs 0% in responders (P=0.0485). With regard to PFS, patients harbouring the -634CC genotype had a median PFS of 2.2 months whereas patients with the genotype -634CG/GG had a median PFS of 6.25 months (P=0.0042).

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