Cigarette smoking and gemcitabine-induced neutropenia in advanced solid tumors
| Autor: | Stephanie Daignault, Patrick N. Healy, Nithya Ramnath, Meaghan O’Malley |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Antimetabolites Antineoplastic Lung Neoplasms Neutropenia medicine.medical_treatment Breast Neoplasms Pharmacology Gastroenterology Deoxycytidine Article chemistry.chemical_compound Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Aged Retrospective Studies Aged 80 and over Chemotherapy business.industry Smoking Retrospective cohort study General Medicine Odds ratio Middle Aged medicine.disease Gemcitabine Pancreatic Neoplasms Biliary Tract Neoplasms Logistic Models Oncology chemistry Pharmacodynamics Toxicity Female business medicine.drug |
| Zdroj: | Oncology. 85(4) |
| ISSN: | 1423-0232 |
| Popis: | Background: Chemotherapy-associated neutropenia has been reported to be a pharmacodynamic marker of response in some advanced solid tumors. Factors that accelerate drug clearance lead to lower plasma concentrations and toxicity, including neutropenia. Smoking accelerates the metabolism of several drugs, including chemotherapy. We sought to study the effects of smoking on gemcitabine-induced neutropenia in this retrospective study. Methods: Smoking status and neutropenia along with other clinical parameters were recorded in 151 patients receiving first-line gemcitabine-based chemotherapy for advanced solid tumors. Results: Tumor types included breast (9.3%), lung (4.6%), pancreatobiliary (70.9%), or other/unknown primary cancer (15.2%). Logistic regression showed that never smokers had increased neutropenia versus current smokers (odds ratio: 3.5; 95% confidence interval, CI: 1.1-11.4). A 5-unit increase in pack-years reduced the odds of having higher neutropenia toxicity by 6.3% (95% CI 12 to 1%; p = 0.036). Conclusion: Smokers had less neutropenia than nonsmokers, a finding that was more pronounced with increasing pack-years. This pharmacodynamic marker of gemcitabine-induced neutropenia may result in less efficacy of gemcitabine. Future prospective trials should correlate smoking, metabolizing phenotype, neutropenia, and response to gemcitabine therapy. |
| Databáze: | OpenAIRE |
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