ABCC Gene Variants and Their Effects on Non-Response and Relapse in Pediatric Patients with Central Nervous System Tumors: A Cohort Study.
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The variability in outcomes among individuals is caused by multiple factors, including genetic variations in drug transporter genes known as ABCs. This study investigates the clinical effect of single-nucleotide variants (SNVs) in the ABCC1/MRP1, ABCC2/MRP2, and ABCC4/MRP4 genes on the clinical response and relapse of pediatric patients with central nervous system tumors. In a cohort-based association study involving 111 cancer patients, genotyping of ABCC1/MRP1, ABCC2/MRP2, and ABCC4/MRP4 was conducted using real-time PCR with TaqMan probes. Treatment response was evaluated using the Response Assessment in Neuro-Oncology (RANO) criteria. Univariate and multivariate analyses were conducted using the Cox proportional hazards (adjusted) model. Multivariate analysis adjusted for sex and age showed a significant association between ABCC1 r.5540out G>C; rs12921623 in the gene and non-response to treatment in the codominant model [HR] 2.095, 95% CI 1.202-3.650, p = 0.009, and in the dominant model [HR] 2.025, 95% CI 1.199-3.421, p = 0.008, and an increased risk of relapse in the codominant model [HR] 9.09, 95% CI 1.04-78.85, p = 0.04, and in the dominant model [HR] 3.912, 95% CI 1.139-13.436, p = 0.03. Furthermore, a significant association was found between ABCC2 c. 3972 C>T; rs3740066 and relapse in the recessive model [HR] 3.5, 95% CI 1.02-12.17, p = 0.04. Our findings indicate that ABCC1 r.5540 G>C SNV and ABCC2 c. 3972 C>T SNV are significant predictors of non-response and relapse in this group of pediatric patients with central nervous system tumors.