ABCG2 C421A polymorphisms affect exposure of the epidermal growth factor receptor inhibitor gefitinib.
ATP-binding castle protein G2 (ABCG2) is thought to inhibit the activities of certain gefitinib transporters, thereby affecting drug pharmacokinetics. The C421A polymorphism affects the function and expression of ABCG2 on the cell membrane. Previous studies have shown that proton-pump inhibitors (PPIs) inhibit gefitinib absorption, as well as the function of ABCG2. We evaluated the plasma concentrations of gefitinib in patients with and without the ABCG2 C421A polymorphism, who were or were not taking PPIs. In total, 61 patients with advanced epidermal-growth-factor-positive non-small-cell lung cancer were enrolled in this study. They were treated with gefitinib at a dose of 250 mg per day. Plasma gefitinib concentration and ABCG2 C421A status were determined after 2 weeks. The patients were divided into CC- and CA/AA genotype groups. We compared the trough and peak gefitinib levels and the area under the curve (AUC) values for 24-h gefitinib concentrations. We also compared these parameters among four groups distinguished according to the presence or absence of the polymorphism and PPI use. The mean trough gefitinib level and AUC value for 24-h gefitinib concentration were significantly lower in the CA/AA group compared to the CC group (mean trough level: 333.2 vs. 454.5 ng/mL, respectively, P = 0.021; AUC: 9949.9 vs. 13,085.4 ng・h/mL, respectively, P = 0.034). Among patients taking PPIs, the mean trough gefitinib level was significantly lower in the CA/AA group than the CC group (220.1 vs. 340.5 ng/mL, respectively, P = 0.033). The CA/AA-type of ABCG2 C421A polymorphism may be associated with lower gefitinib plasma concentrations.
['Sakamoto|Sho|S|', 'Sato|Kazuhiro|K|', 'Takita|Yuri|Y|', 'Izumiya|Yuka|Y|', 'Kumagai|Naho|N|', 'Sudo|Kazuhisa|K|', 'Hasegawa|Yukiyasu|Y|', 'Yokota|Hayato|H|', 'Akamine|Yumiko|Y|', 'Okuda|Yuji|Y|', 'Asano|Mariko|M|', 'Takeda|Masahide|M|', 'Sano|Masaaki|M|', 'Miura|Masatomo|M|', 'Nakayama|Katsutoshi|K|0000-0002-0141-7081']
D000070997:ATP Binding Cassette Transporter, Subfamily G, Member 2 D000368:Aged D000369:Aged, 80 and over D000970:Antineoplastic Agents D002289:Carcinoma, Non-Small-Cell Lung D066246:ErbB Receptors D005260:Female D000077156:Gefitinib D005838:Genotype D006801:Humans D008175:Lung Neoplasms D008297:Male D008875:Middle Aged D009363:Neoplasm Proteins D020641:Polymorphism, Single Nucleotide D047428:Protein Kinase Inhibitors D054328:Proton Pump Inhibitors
ABCG2 Gefitinib Non-small-cell lung cancer EGFR mutation