Association between CYP2C19 Polymorphisms and Drug Efficacy and Adverse Drug Reactions of Thalidomide in Lung Cancer Patients

Objective To examine the association between CYP2C19 gene polymorphisms and the drug efficacy and adverse drug reactions of thalidomide in lung cancer patients.Methods Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) was used to determine the polymorphisms of CYP2C19 in lung cancer patients.Patients were divided into EM and PM groups according to CYP2C19 genotype.Differences of drug efficacy and adverse reactions between the EM and PM groups were compared.Results Of 77 NSCLC patients,13(16.9%) were PMs.The overall response rates of EM and PM groups were 39.1% and 30.8%,respectively,and the median survival time were 9.0 m and 8.0 m,respectively(P0.05).The one-year survival rates of EM and PM groups were 62.5% and 46.2%,respectively(P0.05).The incidence of nausea,vomiting,diarrhea and dizziness of PM group was higher than that of EM group(P0.05).The stable concentration of EMs was significantly higher than PMs(P0.05).Conclusion The gene polymorphisms of CYP2C19 would not affect the survival time of NSCLC patients receiving thalidomide.The extensive metabolizer of CYP2C19 gene could reduce the incidence of nausea and vomiting in patients after chemotherapy.For patients with poor metabolizer of CYP2C19 gene,small dose of thalidomide was suggested at the beginning,which would reduce the incidence of adverse reactions.