Gastric Cancer

, Volume 22, Issue 4, pp 778–784 | Cite as

Association between UGT1A1 gene polymorphism and safety and efficacy of irinotecan monotherapy as the third-line treatment for advanced gastric cancer

  • Toshifumi YamaguchiEmail author
  • Satoru Iwasa
  • Hirokazu Shoji
  • Yoshitaka Honma
  • Atsuo Takashima
  • Ken Kato
  • Tetsuya Hamaguchi
  • Kazuhide Higuchi
  • Narikazu Boku
Original Article



While uridine diphosphate glucuronosyltransferase (UGT) 1A1 is a key enzyme in the metabolism of irinotecan, relationship between UGT1A1 genotype and safety and efficacy of irinotecan monotherapy in patients with advanced gastric cancer is not clarified.


Efficacy and safety in advanced gastric cancer patients, who were tested for UGT1A1*6 and *28 genotype and treated with irinotecan monotherapy as third-line treatment from 2009 to 2014, were evaluated according to the UGT1A1*6 and *28 genotypes.


Among 74 patients of the subjects, the genotypes of UGT1A1 were wild-type (WT) in 37 patients (50%), single heterozygosity (SH) in 27 (36.5%) and double heterozygosity or homozygosity (Homo/DH) in 10 (13.5%). The initial dose of irinotecan was reduced in 10 patients (27%) with WT, in 9 (33%) with SH, and in 7 (70%) with Homo/DH. Median overall survival was 6.9 months, 6.3 months, and 2.8 months in the WT, SH and Homo/DH genotypes, associated with median time to treatment failure of 2.4 months, 2.3 months, and 1.3 months, respectively. Among 36 patients with measurable lesion, disease control rates were 47.6%, 41.7% and 33.3% in the WT, SH and Homo/DH genotypes. Grade 3 or higher adverse events of special interest were neutropenia (13%, 22%, and 64% for the WT, SH and Homo/DH genotypes), febrile neutropenia (2%, 7%, and 50%) and diarrhea (6%, 5%, and 21%).


The UGT1A1 polymorphism may be related to the clinical outcomes of irinotecan monotherapy as the third-line treatment for advanced gastric cancer.


Gastric cancer UGT1A1 Irinotecan 


Compliance with ethical standards

Conflict of interest

None of the authors have conflicts of interest to declare.

Research involving human participants

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or substitute for it was obtained from all patients for being included in the study.


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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2019

Authors and Affiliations

  1. 1.Cancer Chemotherapy CenterOsaka Medical College HospitalTakatsukiJapan
  2. 2.Second Department of Internal MedicineOsaka Medical CollegeTakatsukiJapan
  3. 3.Gastrointestinal Oncology DivisionNational Cancer Center HospitalTokyoJapan
  4. 4.Department of Gastrointestinal OncologySaitama Medical University International Medical CenterHidakaJapan

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