Background and objective
Gemcitabine is widely used to treat non-small cell lung cancer (NSCLC). To assess the pharmacogenomic effects of the entire gemcitabine metabolic pathway, we genotyped SNPs within the 17 pathway genes using DNA samples from NSCLC patients treated with gemcitabine to determine the effect of genetic variants within gemcitabine pathway genes on overall survival (OS) of NSCLC patients after treatment of gemcitabine.
Methods
Eight of the 17 pathway genes were resequenced with DNA samples from Coriell lymphoblastoid cell lines (LCLs) using Sanger sequencing for all exons, exon-intron junctions and 5′-, 3′-UTRs. A total of 107 tag SNPs were selected based on the resequencing data for the 8 genes and on HapMap data for the remaining 9 genes, followed by successful genotyping of 394 NSCLC patient DNA samples. Association of SNPs/haplotypes with OS was performed using the Cox regression model, followed by functional studies performed with LCLs and NSCLC cell lines.
Results
5 SNPs in 4 genes (CDA, NT5C2, RRM1, and SLC29A1) showed associations with OS of those NSCLC patients, as well as 9 haplotypes in 4 genes (RRM1, RRM2, SLC28A3, and SLC29A1) with P < 0.05. Genotype imputation using the LCLs was performed for a region of 200kb surrounding those SNPs, followed by association studies with gemcitabine cytotoxicity. Functional studies demonstrated that downregulation of SLC29A1, NT5C2, and RRM1 in NSCLC cell lines altered cell susceptibility to gemcitabine.
Conclusion
These studies help identify biomarkers to predict gemcitabine response in NSCLC, a step toward the individualized chemotherapy of lung cancer.