• Pharmacogenomics · Aug 2017

    Observational Study

    Advanced cancer pain: the search for genetic factors correlated with interindividual variability in opioid requirement.

    • Maja Matic, Joost Lm Jongen, Laure Elens, Saskia N de Wildt, Dick Tibboel, Peter Ae Sillevis Smitt, and Ron Hn van Schaik.
    • Department of Clinical Chemistry, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.
    • Pharmacogenomics. 2017 Aug 1; 18 (12): 1133-1142.

    AimTo assess association between genetic variants and opioid requirement in cancer patients.Materials & MethodsA prospective observational trial of 243 advanced cancer patients with inadequate analgesia treated by the palliative care team was analyzed for ABCB1, ARRB2, COMT, GCH1, IL1RN, KCNJ6, OPRM1, RHBDF2, SCN9A and Stat6 polymorphisms.ResultsFor patients carrying OPRM1 118AG/GG and COMT 472GG (Val158Val) or these genotypes alone, a significant higher median percentage dose increase was observed (95.2% [32.8-345]) compared with OPRM1 118AA and COMT 472GA/AA (158Met allele carriers; 48.5% [0-98.8]; p = 0.0016). No associations were found with morphine equivalent dose after consultation palliative care team or ketamine use.ConclusionPatients with the combined OPRM1 118AG/GG and COMT 472GG genotype required 50% higher dose increase for sufficient analgesia.

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