ABSTRACT:CYP2C8 has a major role in the metabolism of the anticancer agents 13-cis retinoic acid (13cisRA) and paclitaxel. There is evidence that polymorphisms in the CYP2C8 gene contribute to observed interindividual differences in paclitaxel metabolism. However, no studies have been performed to determine the relevance of CYP2C8 polymorphisms to 13cisRA metabolism. In the current study, the effect of two common nonsynonymous CYP2C8 polymorphisms, CYP2C8*3 (R139K and K399R) and *4 (I264M), on the metabolism of 13cisRA and paclitaxel was examined using an Escherichia coli expression system with coexpression of human cytochrome P450 reductase. No statistically significant differences in the level of 13cisRA 4-hydroxylase activity were associated with either CYP2C8 allelic variant compared with the wild-type CYP2C8.1 enzyme. Furthermore, no differences were observed for the CYP2C8.3 or CYP2C8.4 enzymes with respect to paclitaxel 6␣-hydroxylase kinetics compared with wild-type CYP2C8.1. However, when the effects of the individual polymorphisms making up the CYP2C8*3 allele were considered, a significantly lower level of paclitaxel 6␣-hydroxylase activity was associated with the K399R enzyme. A lower level of activity was also seen for the R139K enzyme, although this difference was not significant. No differences were observed with respect to 13cisRA 4-hydroxylase activity. We conclude that common CYP2C8 polymorphisms are unlikely to explain reported interindividual variation in 13cisRA or paclitaxel pharmacokinetics.Chemotherapy with 13-cis retinoic acid [(13cisRA) isotretinoin] is integral to the treatment of high-risk neuroblastoma (Matthay et al., 1999(Matthay et al., , 2009). Previous studies have demonstrated a high degree of interpatient variability in the pharmacokinetics and metabolism of 13cisRA . Thus, identification of factors predictive of 13cisRA pharmacokinetics and metabolism may allow the optimization of 13cisRA therapy.Several cytochromes P450 (P450s) have been reported to catalyze the oxidation of 13cisRA, including CYP3A7, 2C8, 4A11, 1B1, 2B6, 2C9, 2C19, and 3A4 Marill et al., 2002). Based on both hepatic expression and overall activity, CYP2C8 is considered to be a major isoform involved in 13cisRA metabolism. Indeed, CYP2C8 plays a major role in the metabolism of a number of therapeutically important drugs, and it is the principal enzyme responsible for the oxidative metabolism of the anticancer agent paclitaxel (Rahman et al., 1994). To date, sixteen CYP2C8 alleles have been described previously (www.cypalleles. ki.se), two of which, CYP2C8*3 and *4, include nonsynonymous polymorphisms commonly seen in whites (Dai et al., 2001;Bahadur et al., 2002;Henningsson et al., 2005). Both the *3 and *4 alleles have been associated with a lower rate of paclitaxel metabolism, based on in vitro approaches using expressed enzymes or liver microsomes, although not all studies agree on the extent of this effect (Dai et al., 2001;Soyama et al., 2001;Bahadur et al., 2002;Taniguchi et al., 2005;Parikh et al., 2...