UTICAJ GENSKIH POLIMORFIZAMA NA TOKSIČNOST PLATINSKE HEMIOTERAPIJE U LEČENJU PACIJENATA SA METASTATSKIM NESITNOĆELIJSKIM KARCINOMOM PLUĆA

  • Jelena Spasic Institut za onkologiju i radiologiju Srbije
  • Davorin Radosavljević Institut za onkologiju i radiologiju Srbije
  • Ljudmila Nagorni Obradović Klinika za pulmologiju, Univerzitetski Klinički Centar Srbije, Medicinski fakultet Univerziteta u Beogradu
Ključne reči: genski polimorfizmi, cisplatin, toksičnost

Sažetak


Karcinom pluća je i dalje među najčešćim i najsmrtonosnijim malignim bolestima u svetu. I pored značajnih pomaka u lečenju uvođenjem ciljane i imunološke terapije, hemioterapija zasnovana na platinskim derivatima zadržava svoje mesto u terapijskom algoritmu. Toksična dejstva platinskih derivata, naročito cisplatine su dobro poznata, javljaju se relativno često i mogu biti ograničavajući faktor za sprovođenje adekvatnog lečenja. Postoje značajne interindividualne razlike kako u efikasnosti, tako i u ispoljenoj toksičnosti hemioterapije koje se ne mogu u potpunosti objasniti osobinama same bolesti. U cilju pronalaženja prediktivnih faktora za ispoljavanje toksičnosti, veliki značaj se daje genskim alteracijama, naročito polimorfizmima jednog nukleotida (SNPs).  Ispitivan je uticaj polimorfizama velikog broja gena uključenih u sisteme popravke DNK, signalne puteve apoptoze, DNK sinteze, transportnih mehanizama, ali su rezultati nekonzistentni i često postoje značajne metodološke razlike među sprovedenim studijama. Jasno je da uticaj polimorfizama na ispoljenu toksičnost nije posledica promene samo jednog gena, pa čak ni nekoliko njih, već da odgovor treba tražiti u epigenskim interakcijama kao i interakcijama sa sredinskim faktorima. Ispitivanje polimorfizama je, međutim, relativno jednostavna i jeftina metoda, te se može koristiti kao jedan od prognostičkih alata u svakodnevnoj kliničkoj praksi.

Reference

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2021/07/21
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