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Association between a glutathione S ‐transferase A1 promoter polymorphism and survival after breast cancer treatment
Author(s) -
Sweeney Carol,
Ambrosone Christine B.,
Joseph Lija,
Stone Angie,
Hutchins Laura F.,
Kadlubar Fred F.,
Coles Brian F.
Publication year - 2002
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.10896
Subject(s) - gstp1 , genotype , breast cancer , medicine , cyclophosphamide , hazard ratio , oncology , allele , gastroenterology , proportional hazards model , population , glutathione , glutathione s transferase , cancer , chemotherapy , immunology , biology , genetics , enzyme , confidence interval , gene , environmental health , biochemistry
Abstract Glutathione S ‐transferase (GST) enzymes detoxify chemotherapeutic drugs, and several studies have reported differences in survival for cancer patients who have variant genotypes for GSTP1, GSTM1 or GSTT1 enzymes. A recently described polymorphism alters hepatic expression of GSTA1, a GST with high activity in glutathione conjugation of metabolites of cyclophosphamide (CP). To consider the possible influence of the reduced‐expression GSTA1*B allele on cancer patient survival, we have conducted a pilot study of breast cancer patients treated with CP‐containing combination chemotherapy. GSTA1 genotype was determined by polymerase chain reaction and restriction fragment length polymorphism. Kaplan‐Meier methods and Cox proportional hazards models were used to evaluate survival in relation to genotype. Among 245 subjects, 35% were GSTA1*A/*A , 49% GSTA1*A/*B and 16% GSTA1*B/*B ; the genotype distribution did not differ by ethnic group, age or stage at diagnosis. Among patients who had 0 or 1 GSTA1*B allele, the proportion surviving at 5 years was 0.66 (95% CI = 0.59–0.72), whereas for GSTA1*B/*B subjects the proportion was higher, 0.86 (95% CI = 0.67–0.95). Significantly reduced hazard of death was observed for GSTA1*B/*B subjects during the first 5 years after diagnosis, hazard ratio (HR) = 0.3, 95% CI = 0.1–0.8. The association varied with time, with no survival difference observed for subjects who survived beyond 5 years. These results, although based on a small study population, describe an apparent difference in survival after treatment for breast cancer according to GSTA1 genotype. Further studies should consider the possible association between the novel GSTA1*B variant and outcomes of cancer therapy. © 2002 Wiley‐Liss, Inc.