Background. The personalized approach implies an individual choice of medicines and their doses for the patient, providing the most effective and safe pharmacotherapy. Objective: analysis of the frequencies of UGT1A1 and DPYD polymorphisms and comparison of genotyping data with irinotecan and 5-fluorouracil-induced toxicity, respectively.Materials and Methods. Venous blood of 94 Caucasian patients (46 men and 48 women, median age 61 years). The *6 and *28 UGT1A1 alleles were identified by pyrosequencing, and the *2А DPYD allele was identified by Real-time PCR.Results. The genotyping of 94 patients with colon cancer did not reveal the *2A SNP in the DPYD gene. The frequency rate of the *6 and *28 alleles of the UGT1A1 gene was 0.346 and 0.016, respectively. 24 % of patients receiving chemotherapy with 5-fluorouracil developed side effects associated with the circulatory system and the gastrointestinal tract. Hematological and nonhematological toxic reactions were noted in 48 % and 50 % of patients receiving irinotecan. Severe bilirubinemia was associated with the *28/*28 UGT1A1 genotype. The presence of a high-risk genotype (*28/*1, *28/*28 UGT1A1) correlated with the development of side effects (p=0.040).Conclusion. The absence of carriers of the *2А DPYD allele in the sample with a significant proportion of pronounced adverse toxic reactions to 5-fluorouracil causes the need for the inclusion of new polymorphisms of the DPYD gene in pharmacogenetic testing. The inclusion of genotyping of UGT1A1 polymorphisms into a complex of preliminary examination is advisable when planning treatment with irinotecan.
Treatment of patients with hepatocellular carcinoma is a topical issue of modern oncology. This disease is included by the World Health Organization in the list of 130 major causes of morbidity and mortality. The paper describes a clinical case of hepatocellular carcinoma in a patient treated with three action methods: the antitumor drug sorafenib at a dose of 400 mg orally twice daily, hepatic transarterial chemoembolization (performed 5 times) and surgical treatment as extended left hemihepatectomy, cholecystectomy with resection of the bile duct confluence and reconstruction of the right hepatic and S 1 ducts on the frame drainage by Pikovsky, lymphadenectomy of the hepatoduodenal ligament. It demonstrates the efficiency of combining the above three methods (the female patient receives the treatment for 24 months; her condition is satisfactory, ECOG grade 0).