Using Genetic Tests to Predict Anthracycline Cardiotoxicity
Hello, I am Dr. Maurie Markman from Cancer Treatment Centers of America in Philadelphia, Pennsylvania. I wanted to briefly note a very interesting paper that appeared in the Journal of Clinical Oncology, titled "Anthracycline-Related Cardiomyopathy After Childhood Cancer: Role of Polymorphism in Carbonyl Reductase Gene -- A Report From the Children's Oncology Group."
In this study, researchers looked at the specific polymorphisms in this gene in children who had received anthracycline-based chemotherapy. In all, 170 survivors with cardiomyopathy were compared with 317 survivors with no cardiomyopathy. Of importance, this study identified certain polymorphisms that were strongly associated with the potential risks of developing anthracycline-related cardiomyopathy. In fact, doses as low as 100-150 mg/m2 were associated with development of cardiomyopathy.
This is an important paper because it suggests for the first time that it might be possible to predict the risk for a particular toxicity in a child who is going to receive chemotherapy before that therapy is delivered, on the basis of baseline genetic characteristics. It is very likely that similar results will be available for other toxicities, on the basis of polymorphisms that are present in the individual receiving therapy. This may relate to chemotherapy, radiation therapy, or more targeted therapies that will be used in the future.
The future is quite clear. Not only will we be able to have a favorable impact on toxicities experienced by patients by identifying risks, but we will also be able to take precautionary actions. In this case, perhaps we would use medications other than anthracyclines when there is a known risk.
I encourage you to read this very interesting paper, which is clearly a sign of things to come regarding our ability to look at risks of cancer therapies to patients who are receiving these increasingly effective treatments. Thank you for your attention