Associations between ABCG2 gene polymorphisms and gefitinib toxicity in non-small cell lung cancer: a meta-analysis

Lina Tang,1,* Chunling Zhang,2,* Hairong He,3 Zhenyu Pan,3,4 Di Fan,1 Yinli He,1 Haisheng You,1 Yuanjie Li5 1Department of Pharmacy, The First Affiliated Hospital, Xi’an Jiao Tong University, Xi’an, China; 2Department of Pharmacy, Hong-Hui Hospital, Xi’an Jiao Tong University College of Medicine, Xi’an, China; 3Clinical Research Center, The First Affiliated Hospital, Xi’an Jiao Tong University, Xi’an, China; 4Department of Pharmacy, Xi’an Jiao Tong University Affiliated Children’s Hospital, Xi’an, China; 5Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi’an Jiao Tong University Health Science Center, Xi’an, China *These authors contributed equally to this work Background: Gefitinib is frequently used to treat patients with non-small cell lung cancer (NSCLC) and is excreted out from cells via the ATP-binding cassette transporter ABCG2. ABCG2 gene polymorphisms have been suggested to be associated with ABCG2 protein expression and function and may influence the risk of gefitinib toxicity in NSCLC patients. Previous studies on the associations between ABCG2 gene polymorphisms and the toxicity of gefitinib in NSCLC patients have produced conflicting results. The aim of this meta-analysis was to determine whether ABCG2 gene polymorphisms are associated with the risk of gefitinib-induced toxicity in NSCLC patients.Methods: The PubMed and EMBASE databases were searched systematically for all eligible studies. A relative risk with corresponding 95% CI was calculated to evaluate the associations between ABCG2 gene polymorphisms and gefitinib-induced toxicity.Results: Data were finally extracted from seven studies and 515 patients were found to meet the inclusion criteria of the meta-analysis. A dominant model showed that there was no significant association between the ABCG2 C421A polymorphism and the risk of gefitinib-induced toxicity, while the ABCG2 G34A polymorphism might be associated with an increased risk of skin toxicity in gefitinib therapy (relative risk =1.54, 95% CI 1.08–2.21, P=0.02). However, more reliable data are required to confirm the associations between the ABCG2 C421A and ABCG2 G34A polymorphisms and the toxicity of gefitinib in NSCLC patients.Conclusion: While the ABCG2 C421A polymorphism might not be a reliable marker of gefitinib-related toxicity, the ABCG2 G34A genotype may be predictive of the skin toxicity of gefitinib in NSCLC patients. These conclusions need to be verified in further large-scale studies. Keywords: gefitinib, ABCG2, meta-analysis, polymorphism, toxicity, NSCLC&nbsp