Current opinion on the pharmacogenomics of paclitaxel-induced toxicity

Zeina N. Al-Mahayri, Mohammad M. AlAhmad, Bassam R. Ali

Research output: Contribution to journalReview articlepeer-review

22 Citations (Scopus)


Introduction: Paclitaxel is a microtubule stabilizer that is currently one of the most utilized chemotherapeutic agents. Its efficacy in breast, uterine, lung and other neoplasms made its safety profile enhancement a subject of great interest. Neurotoxicity is the most common paclitaxel-associated toxicities. In addition, hypersensitivity reactions, hematological, gastrointestinal, and cardiac toxicities are all encountered. Areas covered: The current review explores paclitaxel-induced toxicities mechanisms and risk factors. Studies investigating these toxicities pharmacogenomic biomarkers are reviewed and summarized. There is a limited margin of consistency between the retrieved associations. Variants in genes related to neuro-sensitivity are the most promising candidates for future studies. Expert opinion: Genome-wide association studies highlighted multiple-candidate biomarkers relevant to neuro-sensitivity. Most of the identified paclitaxel-neurotoxicity candidate genes are derived from congenital neuropathy and diabetic-induced neurotoxicity pathways. Future studies should explore these sets of genes while considering the multifactorial nature of paclitaxel-induced neurotoxicity. In the absence of certain paclitaxel-toxicity biomarkers, future research should avoid earlier studies’ caveats. Genes in paclitaxel’s pharmacokinetic pathways could not provide consistent results in any of its associated toxicities. There is a need to dig deeper into toxicity-development mechanisms and personal vulnerability factors, rather than targeting only the genes suspected to affect drug exposure.

Original languageEnglish
Pages (from-to)785-801
Number of pages17
JournalExpert Opinion on Drug Metabolism and Toxicology
Issue number7
Publication statusPublished - 2021


  • Paclitaxel-induced toxicities
  • biomarkers
  • cancer
  • chemotherapy-induced neurotoxicity
  • genome-wide association study (GWAS)
  • pharmacogenomics
  • targeted-gene studies

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology


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