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Morphine has been widely used in moderate and severe cancer pain, particularly in palliative care. However, up to 30% of patients do not respond to morphine and have poor outcomes such as insufficient analgesic control or intolerable adverse effects. These interindividual differences are partly attributed to genetic factors. This review discusses the impact of genetic variants affecting morphine treatment responses, particularly in cancer patients. Some genes associated with morphine have been studied in cancer patients, including UGT2B7, COMT, ABCB1, ABCC3, OCT1, OPRM1, βarrestin2, and STAT6. Nevertheless, mixed results were reported for these genetic variants. Thus, there are limited pharmacogenetic implications of these genetic variants in cancer patients due to inadequate evidence. Further investigations with careful study design are required to unveil their impacts. As personalized medicine in cancer treatment is being considered these days, inter-individual genetic variants should also be evaluated for palliative care. Pharmacogenomics holds the potential to optimize morphine treatment outcomes with more investigations in the future for its relevancy in cancer patients.

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Interplay Between Genetic Variants and Morphine: Toward Personalized Medicine in Cancer Pain Management

  • 章节

  • 发表日期：

    2024年

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  • Mohd Makmor Bakry,
  • Hasniza Zaman Huri,
  • Vijayaprakash Suppiah,
  • Gaik Theng Toh,
  • Eng Wee Chua,
  • Sui Ling Janet Tan,
  • Hui Yin Yow

摘要

Morphine has been widely used in moderate and severe cancer pain, particularly in palliative care. However, up to 30% of patients do not respond to morphine and have poor outcomes such as insufficient analgesic control or intolerable adverse effects. These interindividual differences are partly attributed to genetic factors. This review discusses the impact of genetic variants affecting morphine treatment responses, particularly in cancer patients. Some genes associated with morphine have been studied in cancer patients, including UGT2B7, COMT, ABCB1, ABCC3, OCT1, OPRM1, βarrestin2, and STAT6. Nevertheless, mixed results were reported for these genetic variants. Thus, there are limited pharmacogenetic implications of these genetic variants in cancer patients due to inadequate evidence. Further investigations with careful study design are required to unveil their impacts. As personalized medicine in cancer treatment is being considered these days, inter-individual genetic variants should also be evaluated for palliative care. Pharmacogenomics holds the potential to optimize morphine treatment outcomes with more investigations in the future for its relevancy in cancer patients.