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Impact of Genetic Variants on the Toxicity of Antibody-Drug Conjugates in Locally Advanced or Metastatic Breast Cancer: The Role of the UGT1A1 Gene as a Predictive Biomarker of Therapeutic Response

2026年5月6日 更新者：Isabel Blancas López Barajas、Fundación Pública Andaluza para la Investigación Biomédica Andalucía Oriental

The metabolism of anticancer drugs is influenced by genetic variants that affect their bioavailability and toxicity. In the case of antibody-drug conjugates (ADCs), such as sacituzumab-govitecan (SG), trastuzumab-deruxtecan (T-DXd), and datopotamab-deruxtecan (Dato-DXd), the enzyme UDP-glucuronosyltransferase 1A1 (UGT1A1) plays a central role in the glucuronidation and elimination of their cytotoxic components. In particular, the metabolism of SN-38, the active metabolite of irinotecan and SG, is highly influenced by variants in UGT1A1, leading to drug accumulation and the development of severe toxicities. Patients with variants such as UGT1A1*28 (rs3064744) and UGT1A1*6 (rs4148323) exhibit reduced enzyme activity, increasing the risk of neutropenia and severe diarrhea.

The relevance of UGT1A1 is not limited to sacituzumab-govitecan; its role in the elimination of camptothecin derivatives suggests it could also impact the toxicity of trastuzumab-deruxtecan and datopotamab-deruxtecan, which contain deruxtecan, a cytotoxic agent 10 times more potent than irinotecan. Despite strong evidence linking the UGT1A1 genotype to irinotecan toxicity, there are currently no established pharmacogenetic recommendations for antidiuretic peptides (ADCs) in metastatic breast cancer.

研究概览

地位

招聘中

条件

干预/治疗

研究类型

观察性的

注册 (估计的)

70

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

学习地点

  • 西班牙
    • Granada
      • Granada、Granada、西班牙、18016
        • 招聘中
        • Hospital Universitario Clínico San Cecilio
        • 接触：
        • 首席研究员：
          • Isabel Blancas López-Barajas, MD, PhD

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 成人
  • 年长者

接受健康志愿者

不

取样方法

非概率样本

研究人群

Patients with early, locally advanced, or metastatic breast cancer treated with antibody-drug conjugates in a real-world clinical setting at a single tertiary hospital.

描述

Inclusion Criteria:

  • Patients aged 18 years or older.
  • Patients diagnosed with breast cancer starting or undergoing treatment with Sacituzumab Govitecan, Trastuzumab Deruxtecan, or Datopotamab Deruxtecan.
  • Provision of signed informed consent for the genetic study.

Exclusion Criteria:

  • Patients who are ultimately not treated with the specified Antibody-Drug Conjugates.
  • Refusal to provide informed consent for genetic analysis.

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

队列和干预

团体/队列
干预/治疗
Patients undergoing treatment with sacituzumab govitecan
Standard clinical dose of sacituzumab govitecan administered as per routine clinical practice.
药品：Sacituzumab Govitecan
Administered according to standard clinical practice and product label.
Patients undergoing treatment with trastuzumab-deruxtecan
Standard clinical dose of trastuzumab-deruxtecan administered as per routine clinical practice.
药品：Trastuzumab deruxtecan
Administered according to standard clinical practice and product label.
Patients undergoing treatment with datopotamab deruxtecan
Standard clinical dose of datopotamab deruxtecan administered as per routine clinical practice.
药品：Datopotamab Deruxtecan
Administered according to standard clinical practice and product label.

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Incidence of Severe Drug-Related Toxicities (Grade ≥ 3)
大体时间：From the start of treatment until the end of the follow-up period (up to 2 years).
Number of patients experiencing severe hematological or gastrointestinal toxicities (defined as Grade 3 or higher according to CTCAE v5.0) that are definitely, probably, or possibly related to the treatment with Sacituzumab Govitecan, Trastuzumab Deruxtecan, or Datopotamab Deruxtecan.
From the start of treatment until the end of the follow-up period (up to 2 years).

次要结果测量

结果测量
措施说明
大体时间
Frequency of UGT1A1*28 Allele
大体时间：At baseline (once the genetic study is performed).
Distribution and allelic frequency of the UGT1A1*28 variant in the study population of breast cancer patients.
At baseline (once the genetic study is performed).
Correlation Between Genetic Variants and Toxicity Severity
大体时间：Analyzed at the completion of the 2-year study period.
Statistical association (using Odds Ratio) between the identified genetic variants (rs4148323, rs35350906, rs3064744, rs887829, rs111741722) and the severity of adverse events.
Analyzed at the completion of the 2-year study period.
Predictive Model for Severe Toxicity
大体时间：At the end of the study (2 years).
Design of a predictive model based on genetic markers to anticipate the appearance of severe toxicities for each ADC studied.
At the end of the study (2 years).

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Fundación Pública Andaluza para la Investigación Biomédica Andalucía Oriental

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

一般刊物

有用的网址

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2025年7月15日

初级完成 (估计的)

2026年12月31日

研究完成 (估计的)

2027年3月31日

研究注册日期

首次提交

2026年5月6日

首先提交符合 QC 标准的

2026年5月6日

首次发布 (实际的)

2026年5月13日

研究记录更新

最后更新发布 (实际的)

2026年5月13日

上次提交的符合 QC 标准的更新

2026年5月6日

最后验证

2026年5月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • FIB-MAM-2025-04

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

不

IPD 计划说明

Individual participant data will not be shared to ensure patient confidentiality and compliance with data protection regulations. Aggregate results will be available through scientific publications.

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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