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Anastrozole Aromatase Inhibitor Plasma Drug Concentration Genome-Wide Association Study: Functional Epistatic Interaction Between SLC38A7 and ALPPL2.

Abstract
Anastrozole is a widely prescribed aromatase inhibitor for the therapy of estrogen receptor positive (ER+) breast cancer. We performed a genome-wide association study (GWAS) for plasma anastrozole concentrations in 687 postmenopausal women with ER+ breast cancer. The top single-nucleotide polymorphism (SNP) signal mapped across SLC38A7 (rs11648166, P = 2.3E-08), which we showed to encode an anastrozole influx transporter. The second most significant signal (rs28845026, P = 5.4E-08) mapped near ALPPL2 and displayed epistasis with the SLC38A7 signal. Both of these SNPs were cis expression quantitative trait loci (eQTL)s for these genes, and patients homozygous for variant genotypes for both SNPs had the highest drug concentrations, the highest SLC38A7 expression, and the lowest ALPPL2 expression. In summary, our GWAS identified a novel gene encoding an anastrozole transporter, SLC38A7, as well as epistatic interaction between SNPs in that gene and SNPs near ALPPL2 that influenced both the expression of the transporter and anastrozole plasma concentrations.
AuthorsTanda M Dudenkov, Duan Liu, Junmei Cairns, Sandhya Devarajan, Yongxian Zhuang, James N Ingle, Aman U Buzdar, Mark E Robson, Michiaki Kubo, Anthony Batzler, Poulami Barman, Gregory D Jenkins, Erin E Carlson, Matthew P Goetz, Donald W Northfelt, Alvaro Moreno-Aspitia, Zeruesenay Desta, Joel M Reid, Krishna R Kalari, Liewei Wang, Richard M Weinshilboum
JournalClinical pharmacology and therapeutics (Clin Pharmacol Ther) Vol. 106 Issue 1 Pg. 219-227 (07 2019) ISSN: 1532-6535 [Electronic] United States
PMID30648747 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Copyright© 2019 The Authors Clinical Pharmacology & Therapeutics published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.
Chemical References
  • Aromatase Inhibitors
  • GPI-Linked Proteins
  • Receptors, Estrogen
  • Anastrozole
  • ALPG protein, human
  • Alkaline Phosphatase
Topics
  • Alkaline Phosphatase (genetics)
  • Anastrozole (blood, pharmacokinetics, therapeutic use)
  • Aromatase Inhibitors (blood, pharmacokinetics, therapeutic use)
  • Breast Neoplasms (drug therapy)
  • Chromosomes, Human, Pair 16 (genetics)
  • Chromosomes, Human, Pair 2 (genetics)
  • Epistasis, Genetic (genetics)
  • Female
  • GPI-Linked Proteins (genetics)
  • Genome-Wide Association Study
  • Genotype
  • Humans
  • Polymorphism, Single Nucleotide
  • Postmenopause
  • Receptors, Estrogen (biosynthesis)

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