Doctor of Philosophy, The Ohio State University, 2024, Molecular Genetics
Breast cancer, predominantly characterized by hormone receptor-positive tumors, poses a significant global health concern. Aromatase inhibitors (AIs) such as anastrozole, letrozole, and exemestane have emerged as pivotal therapies for postmenopausal women, offering superior outcomes compared to conventional treatments. However, their effectiveness is hampered by notable side effects, especially Aromatase Inhibitor-Associated Arthralgia (AIAA), which profoundly impacts patient well-being and treatment compliance. Understanding the pharmacokinetics and pharmacodynamics of AIs is essential for optimizing therapeutic strategies and managing adverse effects.
We hypothesized that genetic variations in drug-metabolizing enzymes and transporters could contribute to variability in plasma AI concentrations among individuals, potentially influencing the onset of side effects. AIAA, characterized by joint pain and stiffness, remains a subject of intense research, with animal models providing insights into its pathophysiology, albeit requiring further validation.
In this study, we developed two simple, precise, and accurate liquid chromatography-mass spectrometry methods for quantifying letrozole and exemestane, representing nonsteroidal and steroidal AIs, respectively. These methods were subsequently applied to measure AIs concentrations in mouse plasma and tissues, allowing for the precise assessment of drug pharmacokinetics across different mouse strains. Various interconnected approaches using in silico, in vitro, and in vivo models revealed intricate interaction of AIs and OATP1B-type transporters. A mouse model was established to further simulate AIAA and investigate the role of transporters in arthralgia development.
Lastly, we validated a biomarker that could potentially serve to identify patients with breast cancer who are at risk of AIAA development. This biomarker reflects the activity of a transporter involved in the elimination of AIs and holds promise for indivi (open full item for complete abstract)
Committee: Shuiying Hu (Advisor); Alex Sparreboom (Advisor)
Subjects: Pharmacology