Genetic variants associated with methotrexate-induced mucositis in cancer treatment: A systematic review and meta-analysis

Crit Rev Oncol Hematol. 2021 May:161:103312. doi: 10.1016/j.critrevonc.2021.103312. Epub 2021 Mar 29.

Abstract

Methotrexate (MTX), an important chemotherapeutic agent, is often accompanied with mucositis. The occurrence and severity are unpredictable and show large interindividual variability. In this study, we review and meta-analyze previously studied genetic variants in relation to MTX-induced mucositis. We conducted a systematic search in Medline and Embase. We included genetic association studies of MTX-induced mucositis in cancer patients. A meta-analysis was conducted for single nucleotide polymorphisms (SNPs) for which at least two studies found a statistically significant association. A total of 34 SNPs were associated with mucositis in at least one study of the 57 included studies. Two of the seven SNPs included in our meta-analysis were statistically significantly associated with mucositis: MTHFR c.677C > T (recessive, grade ≥3 vs grade 0-2, OR 2.53, 95 %CI [1.48-4.32], False Discovery Rate[FDR]-corrected p-value 0.011) and MTRR c.66A > G (overdominant, grade ≥1 vs grade 0, OR 2.08, 95 %CI [1.16-3.73], FDR-corrected p-value 0.042).

Keywords: Adult; Cancer; Gastrointestinal toxicity; Methotrexate; Mucositis; Pediatric; Pharmacogenomics.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Antimetabolites, Antineoplastic / adverse effects
  • Humans
  • Methotrexate / adverse effects
  • Methylenetetrahydrofolate Reductase (NADPH2) / genetics
  • Mucositis* / chemically induced
  • Mucositis* / genetics
  • Neoplasms* / drug therapy
  • Neoplasms* / genetics
  • Polymorphism, Single Nucleotide

Substances

  • Antimetabolites, Antineoplastic
  • Methylenetetrahydrofolate Reductase (NADPH2)
  • Methotrexate