Genetic variability of DNA repair mechanisms and glutathione-S-transferase genes influences treatment outcome in osteosarcoma

• Osteosarcoma patients are commonly treated with cisplatin-based chemotherapy.
• Polymorphisms in DNA repair or GST genes may affect cisplatin treatment outcome.
• ERCC2 rs1799793 was associated with longer event-free survival.
• GSTP1 rs1138272 was associated with shorter event-free and overall survival.
• ERCC2 and GSTP1 could act as predictors of cisplatin chemotherapy in osteosarcoma.

BackgroundOsteosarcoma patients are commonly treated with cisplatin-based preoperative and postoperative chemotherapy. Cisplatin binds to DNA and forms both intrastrand and interstrand crosslinks, inhibiting DNA replication. Glutathione-S-transferases (GSTs) participate in cisplatin detoxification, while several independent DNA repair mechanisms repair cisplatin-induced lesions. The aim of our study was to investigate the influence of genetic variability of DNA repair mechanisms and GSTs on efficacy and toxicity of cisplatin-based chemotherapy in osteosarcoma patients.MethodsA total of 66 osteosarcoma patients were genotyped for ERCC1, ERCC2, NBN, RAD51, XRCC3, and GSTP1 polymorphisms, as well as GSTM1 and GSTT1 gene deletion. We determined the influence of polymorphisms on survival and treatment outcome using Cox regression and logistic regression.ResultsCarriers of at least one polymorphic ERCC2 rs1799793 allele had longer event-free survival (EFS) (P = 0.006; hazard ratio (HR) = 0.28; 95% confidence interval (CI) = 0.11–0.70). Polymorphic GSTP1 rs1138272 allele was associated with both shorter EFS and OS (P = 0.005; HR = 3.67; 95%CI = 1.47–9.16; and P = 0.004; HR = 3.52; 95%CI = 1.51–8.22, respectively). Compared to the reference NBN CAA haplotype, NBN CGA haplotype was associated with shorter EFS (P = 0.001; HR = 4.12; 95%CI = 1.77–9.56).ConclusionsOur results suggest that DNA repair polymorphisms and GST polymorphisms could be used as predictive factors for cisplatin-based chemotherapy in osteosarcoma patients and could contribute to treatment personalization.