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Does Pharmacogenomics Account for Variability in Control of Acute Chemotherapy-Induced Nausea and Vomiting with 5-Hydroxytryptamine Type 3 Receptor Antagonists?

  • Palliative Medicine (A Jatoi, Section Editor)
  • Published:
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Abstract

Chemotherapy-induced nausea and vomiting is one of the most concerning adverse drug effects from cytotoxic chemotherapy. Despite appropriate use of antiemetic guidelines, 20–30 % of patients experience breakthrough nausea and vomiting secondary to chemotherapy. To assess the variability of 5-hydroxytryptamine type 3 receptor antagonist efficacy caused by genetic variation, a review of the available literature was conducted. From the literature, three sources of pharmacogenomic variability were identified: polymorphisms associated with 5-hydroxytryptamine type 3 receptor subunits, drug metabolism via cytochromes P450, and drug transport in the body. Testing for receptor subunit polymorphisms is not applicable to a clinical setting at this time; however, cytochrome P450 2D6 testing is FDA-approved and widely accessible. Cytochrome P450 2D6 ultrarapid metabolizers and poor metabolizers displayed altered antiemetic efficacy when compared with intermediate metabolizers and extensive metabolizers. We postulate that testing for cytochrome P450 2D6 phenotypes may be the most accessible way to provide individualized antiemetic therapy in the future.

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Conflict of Interest

Morgan Trammel declares no conflict of interest.

Mary Roederer declares no conflict of interest.

Jai Patel declares no conflict of interest.

Howard McLeod declares no conflict of interest.

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Authors and Affiliations

  1. Eshelman School of Pharmacy, University of North Carolina, Campus Box 7355, Chapel Hill, NC, 27599-7355, USA

    Morgan Trammel, Mary Roederer, Jai Patel & Howard McLeod

  2. Institute for Pharmacogenomics & Individualized Therapy, University of North Carolina, 1070 Genetic Medicine Building, 120 Mason Farm Road, Campus Box 7361, Chapel Hill, NC, 27599-7361, USA

    Mary Roederer, Jai Patel & Howard McLeod

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  1. Morgan Trammel
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Correspondence to Howard McLeod.

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Trammel, M., Roederer, M., Patel, J. et al. Does Pharmacogenomics Account for Variability in Control of Acute Chemotherapy-Induced Nausea and Vomiting with 5-Hydroxytryptamine Type 3 Receptor Antagonists?. Curr Oncol Rep 15, 276–285 (2013). https://doi.org/10.1007/s11912-013-0312-x

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  • DOI: https://doi.org/10.1007/s11912-013-0312-x

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