HCPLive Network

Aromatase Inhibitor-Associated Arthralgia May be Influenced by Genetics

Investigators presented new research that reveals a possible genetic basis for why Aromatase inhibitor-associated arthralgia (AIAA) occurs in breast cancer survivors and shows promise for treating the side effect without interfering with the drug’s efficacy.
 
AIAA produces severe joint pain and as many as 10% of women experiencing AIAA choose to prematurely discontinue their drug treatment as a result.
 
The research was performed by investigators from the University of Pennsylvania’s Abramson Cancer Center and presented during the 2010 meeting of the American Society of Clinical Oncology.
 
The team, led by Jun Mao, MD, MSCE, assistant professor of Family Medicine and Community Health, studied individual genetic variations that could potentially influence both the onset and severity of AIAA. The team studied 390 postmenopausal women with stage 0 to III breast cancer. All the women were receiving adjuvant therapy with aromatase inhibitors who reported joint pain related to their drug therapy.
 
Women carrying at lease one copy of a “7-repeat” genetic variant in the aromatase enzyme (CYP19A1) had a lower chance of developing AAIA than those with at-least one “8-repeat” allele of the same gene. Additionally, having at least one copy of a specific IL-6 haplotype was also correlated with increased pain severity, while the presence of a different variant of that gene was associated with decreased pain.
 
"Due to genetic differences, women respond differently to aromatase inhibitors with regard to estrogen levels and inflammatory processes, and as a result, some women are more likely to have this pain or have more severe pain," said Angela DeMichele, MD, MSCE, an associate professor of Hematology/Oncology and Epidemiology and Biostatistics, and a co-author on all three of the studies, in a news release. "There are millions of women receiving AIs, as many as 50 percent of them experience some level of arthralgia, and up to 10 percent discontinue their treatment prematurely, so this is a significant issue."
 


Further Reading
Paul J. Christo, MD provides an overview of the prevalence of pain in older adults while discussing physiological age-associated changes in pain processing.
MDNG: Pain Management Edition is seeking nominations for the 2010 Pain Innovators of the Year Awards.
In laboratory studies, morphine can directly boost tumor-cell proliferation and inhibit the immune response. Researchers also found that opiates promote angiogenesis.
Systematic literature review confirms that a range of opioid formulations and delivery methods provide safe and effective treatment options for cancer pain.
Besides the immediate impact of improperly treated pain, children can experience long-Lasting consequences.
Attendees at the ONS Congress are still energized on the start of day three of the conference. Today’s sessions covered a wide range of topics ranging from long-term care of breast cancer survivors to treatment of metastatic disease.
For those treating pediatric patients, the task of identifying symptoms and measuring the levels of pain being experienced is a bit more complicated.
More Reading