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Personalised medicine in oncology: A new study helps predict the risk of serious side effects from chemotherapy

PublicationResearch Published on 25. 07. 2025 Reading time Reading time: 2 minutes

Chemotherapy helps prolong the lives of patients with colorectal cancer, but it often comes with serious side effects. These can significantly impair quality of life, sometimes requiring treatment to be interrupted and, in extreme cases, can even be life-threatening. But why do some patients react so dramatically to drugs, while others tolerate them without severe problems?

A new study published in the prestigious British Journal of Pharmacology (IF 7.7)(open in a new window) seeks to answer this question. This is the second international publication in a short period in which geneticist Veronika Vymetálková from the Deparment of Molecular Biology of Cancer has co-authored. The study aimed to find genetic variants that could help predict who is at higher risk of serious side effects.

The research team analysed genetic information from 163 patients who experienced serious side effects (grade 3–4 according to the international scale) during chemotherapy and compared it with genetic data from 52 patients without these complications. Using whole-genome sequencing, they discovered several known and previously undescribed genetic changes that could be related to the toxicity of the treatment. One of the main findings was a new potentially risky variant in the DPYD gene, which plays an essential role in drug metabolism. The researchers also identified 30 other unique mutations in 14 genes that could affect sensitivity to chemotherapy, for example, in relation to nerve, skin, or heart damage. At the same time, they discovered three previously undescribed genes – ALDH9A1, FAM83A, and EPX, which they identified as possible candidates associated with treatment toxicity. Another interesting finding is the discovery of so-called digenic inheritance, where a combination of variants in two different genes can together increase the risk of side effects. These discoveries open up a more accurate and safer approach to cancer treatment.

We would like to contribute to genetic testing gradually becoming a standard part of treatment planning. Information about the presence of certain genetic variants could help doctors better tailor treatment dosages or choose a more appropriate type of treatment in the future,” explains Veronika Vymetálková, co-author of the study. This approach is the basis of personalised medicine, i.e., treatment tailored to the specific patient.