Background. Irinotecan (CPT-11) is metabolized by esterase to form a S
N-38, which is further conjugated by UGT1A1. Genetic polymorphism has
been shown in a promoter region of UGT1A1 and is related to its activi
ty, We investigated whether there might be an inter-individual differe
nce in pharmacokinetics of SN-38 and its glucuronide, depending on the
genotypes of UGT1A1. Patients and methods: Nine male patients with lu
ng cancer were treated with irinotecan (50 mg/m(2)) and carboplatin. P
harmacokinetic parameters were calculated with full sampling plasma da
ta. Genotypes were determined by analyzing the sequence of TATA box of
UGT1A1 of genomic DNA from the patients. Results: The genotyping anal
ysis revealed one heterozygote (6/7) and one homozygote (7/7) for (TA)
(7)TAA allele (UGT1A128). The remaining seven patients were homozygot
e for (TA)(6)TAA allele (6/6, wild type). The metabolic ratios (SN-38/
SN-38 glucuronide) in the patient with 7/7 genotype were uncharacteris
tically higher than those in the patients with other genotypes (6/6 an
d 6/7). Biliary index was 6980 versus 2180 +/- 1110 (range 840-3730) i
n patients with 7/7 versus 6/6 genotypes, respectively. Conclusion: Th
ese results support the idea that the patient with 7/7 genotype has an
impaired capacity for glucuronidation of SN-38.