Pharmacogenetic Discovery in CALGB (Alliance) 90401 and Mechanistic Validation of a VAC14 Polymorphism that Increases Risk of Docetaxel-Induced Neuropathy.

Journal Article (Clinical Trial, Phase III;Journal Article)

PURPOSE: Discovery of SNPs that predict a patient's risk of docetaxel-induced neuropathy would enable treatment individualization to maximize efficacy and avoid unnecessary toxicity. The objectives of this analysis were to discover SNPs associated with docetaxel-induced neuropathy and mechanistically validate these associations in preclinical models of drug-induced neuropathy. EXPERIMENTAL DESIGN: A genome-wide association study was conducted in metastatic castrate-resistant prostate cancer patients treated with docetaxel, prednisone and randomized to bevacizumab or placebo on CALGB 90401. SNPs were genotyped on the Illumina HumanHap610-Quad platform followed by rigorous quality control. The inference was conducted on the cumulative dose at occurrence of grade 3+ sensory neuropathy using a cause-specific hazard model that accounted for early treatment discontinuation. Genes with SNPs significantly associated with neuropathy were knocked down in cellular and mouse models of drug-induced neuropathy. RESULTS: A total of 498,081 SNPs were analyzed in 623 Caucasian patients, 50 (8%) of whom experienced grade 3+ neuropathy. The 1,000 SNPs most associated with neuropathy clustered in relevant pathways including neuropathic pain and axonal guidance. An SNP in VAC14 (rs875858) surpassed genome-wide significance (P = 2.12 × 10-8, adjusted P = 5.88 × 10-7). siRNA knockdown of VAC14 in stem cell-derived peripheral neuronal cells increased docetaxel sensitivity as measured by decreased neurite processes (P = 0.0015) and branches (P < 0.0001). Prior to docetaxel treatment, VAC14 heterozygous mice had greater nociceptive sensitivity than wild-type litter mate controls (P = 0.001). CONCLUSIONS: VAC14 should be prioritized for further validation of its potential role as a predictor of docetaxel-induced neuropathy and biomarker for treatment individualization. Clin Cancer Res; 22(19); 4890-900. ©2016 AACR.

Full Text

Duke Authors

Cited Authors

  • Hertz, DL; Owzar, K; Lessans, S; Wing, C; Jiang, C; Kelly, WK; Patel, J; Halabi, S; Furukawa, Y; Wheeler, HE; Sibley, AB; Lassiter, C; Weisman, L; Watson, D; Krens, SD; Mulkey, F; Renn, CL; Small, EJ; Febbo, PG; Shterev, I; Kroetz, DL; Friedman, PN; Mahoney, JF; Carducci, MA; Kelley, MJ; Nakamura, Y; Kubo, M; Dorsey, SG; Dolan, ME; Morris, MJ; Ratain, MJ; McLeod, HL

Published Date

  • October 1, 2016

Published In

Volume / Issue

  • 22 / 19

Start / End Page

  • 4890 - 4900

PubMed ID

  • 27143689

Pubmed Central ID

  • PMC5050068

Electronic International Standard Serial Number (EISSN)

  • 1557-3265

Digital Object Identifier (DOI)

  • 10.1158/1078-0432.CCR-15-2823


  • eng

Conference Location

  • United States