Skip to main content
Log in

Cytochrome P-450IID6 phenotyping in cancer patients: debrisoquin and dextromethorphan as probes

  • Original Article
  • Cytochrome P-450IID6, Debrisoquine, Dextromethorphan
  • Published:
Cancer Chemotherapy and Pharmacology Aims and scope Submit manuscript

Abstract

The usefulness of substituting dextromethorphan for debrisoquin as a probe for cytochrome P450IID6 deficiency was investigated in 20 male cancer patients. Each patient was studied on two occasions. An oral dose of dextromethorphan (60 mg) was administered to 13 patients and are week later an oral dose of debrisoquin (10 mg) was administered to each patient. The order was reversed for the other 7 patients. An 8-h urine sample was collected after administration of each test drug and assayed for parent drug and metabolites. Five poor metabolizers (PMs) and 15 extensive metabolizers (EMs) of debrisoquin were tested. The debrisoquin metabolic ratio (DMR), calculated as [parent drug]/[metabolite], correlated with the metabolic ratio of dextromethorphan (R 2=0.58,P=0.0001). All PMs of debrisoquin (metabolic ratio >12.0) were easily identified as being PMs of dextromethorphan (metabolic ratio >0.30). Within the EM group, there was a significant correlation between the metabolic ratios of debrisoquin and dextromethorphan (R 2=0.82, P<0.0001). There was not as clear a correlation in the PM group (R 2=0.32, P=0.32). These findings suggest that dextromethorphan can be substituted for debrisoquin in establishing the debrisoquin phenotype in a patient population with metastatic cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Alvan G (1991) Clinical consequences of polymorphic drug oxidation. Fundam Clin Pharmacol 5: 209

    Google Scholar 

  2. Ayesh R, Idle JR, Ritchie JC, Crothers MJ, Hetzel MR (1984) Metabolic oxidation phenotypes as markers for susceptibility to lung cancer. Nature 312: 169

    Google Scholar 

  3. Balant L, Gundert-Remy U, Boobis A, von Bahr C (1989) Relevance of genetic polymorphism in drug metabolism in the development of new drugs. Eur J Clin Pharmacol 36: 551

    Google Scholar 

  4. Benitez J, Ladero JM, Fernandez-Gundin MJ, Llerena A, Cobaleda J, Martinez C, Munoz JJ, Vargas E, Prados J, Gonzalez-Rozas F, et al (1990) Polymorphic oxidation of debrisoquine in bladder cancer. Ann Med 22: 157

    Google Scholar 

  5. Brosen K, Gram LF (1989) Clinical significance of the sparteine/debrisoquin oxidation polymorphism. Eur J Clin Pharmacol 36: 537

    Google Scholar 

  6. Brosen K, Zeugin T, Meyer U (1991) Role of P-450IID6, the target of the sparteine-debrisoquin oxidation polymorphism, in the metabolism of imipramine. Clin Pharmacol Ther 49: 609

    Google Scholar 

  7. Caporaso N, Shaw G (1991) Clinical implications of the competitive inhibition of the debrisoquin-metabolizing isozyme by quinidine. Arch Intern Med 151: 1985

    Google Scholar 

  8. Caporaso NE, Hayes RB, Dosemeci M, et al (1989) Lung caner risk, occupational exposure, and the debrisoquine metabolic phenotype. Cancer Res 49: 3675

    Google Scholar 

  9. Caporaso NE, Tucker MA, Hoover NA, Hayes RB, Pickle LW, Issaq HJ, Muschik GM, Green-Gallo L, Buivys D, Aisner S, et al (1990) Lung cancer and the debrisoquine metabolic phenotype. J Nall Cancer Inst 82: 126

    Google Scholar 

  10. Colton T (1974) Statistics in medicine. Little, Brown & Company. Boston, p211.

    Google Scholar 

  11. Eichelbaum M, Spannbrucker N, Steinche B, Dengler HJ (1979) Defective N-oxidation of sparteine in man; a new pharmacogenetic defect. Eur J Clin Pharmacol 16: 183

    Google Scholar 

  12. Evans DA, Mahgoub A, Sloan TP, Idle JR, Smith RL (1980) A family and population study of the genetic polymorphism of debrisoquine oxidation in a white British population. J Med Genet 17: 102

    Google Scholar 

  13. Funck-Brentano C, Thomas G, Jacqz-Aigrain E, Poirier JM, Simon T, Bereziat G, Jaillon P (1992) Polymorphism of dextromethorphan metabolism: relationship between phenotype, genotype and response to the administration of encainide in humans. J Pharmacol Ex Ther 263: 780–786

    Google Scholar 

  14. Gaedigk A, Blum M, Gaedigk R, Eichelbaum M, Meyer U (1991) Deletion of the entire cytochrome P450 CYPIID6 gene as a cause of impaired drug metabolism in poor metabolizers of the debrisoquine/sparteine polymorphism. Am J Hum Genet 48: 943

    Google Scholar 

  15. Guengerich FP (1988) Roles of cytochrome P-450 enzymes in chemical carcinogenesis and cancer chemotherapy. Cancer Res 48: 2946

    Google Scholar 

  16. Guttendorf RJ, Wedlund PJ, Blake J, Chang SL (1988) Simplified phenotyping with dextromethorphan by thin-layer chromatography: application to clinical laboratory screening for deficiencies in oxidative drug metabolism. Ther Drug Monit 10: 490

    Google Scholar 

  17. Hildebrand M, Seifert W, Reichenberger A (1989) Determination of dextromethorphan metabolizer phenotype in healthy volunteers. Eur J Clin Pharmacol 36: 315

    Google Scholar 

  18. Idle JR, Mahgoub A, Angelo MM, Dring LG, Lancaster R, Smith RL (1979) The metabolism of (14C) debrisoquine in man. Br J Clin Pharmacol 7: 257

    Google Scholar 

  19. Jacqz E, Hall S, Branch R (1986) Genetically determined polymorphisms in drug oxidation. Hepatology 6: 1020

    Google Scholar 

  20. Knodell R, Browne D, Gwozdz G, Brian W, Guengerich F (1991) Differential inhibition of individual human liver cytochromes P-450 by cimetidine. Gastroenterology 101: 1680

    Google Scholar 

  21. Kupfer A, Schmid B, Preisig R, Pfaff G (1984) Dextromethorphan as a safe probe for debrisoquine hydroxylation polymorphism. Lancet 2: 517

    Google Scholar 

  22. Ladero J, Benitez J, Jara C, et al (1991) Polymorphic oxidation of debrisoquine in women with breast cancer. Oncology 48: 107

    Google Scholar 

  23. Mahgoub A, Idle JR, Dring LG, Lancaster R, Smith RL (1977) Polymorphic hydroxylation of debrisoquine in man. Lancet 1: 584

    Google Scholar 

  24. Nebert D (1991) Role of genetics and drug metabolism in human cancer risk. Mutat Res 247: 267

    Google Scholar 

  25. Schellens J, Ghabrial H, van der Wart H, Bakker E, Wilkinson G, Breimer D (1991) Differential effects of quinidine on the disposition of nifedipine, sparteine, and mephenytoin in humans. Clin Pharmacol Ther 50: 520

    Google Scholar 

  26. Schmid B, Bircher J, Preisig R, Kupfer A (1985) Polymorphic dextromethorphan metabolism: co-segregation of oxidative O-demethylation with debrisoquin hydroxylation. Clin Pharmacol Ther 38: 618

    Google Scholar 

  27. Steiner E, Iselius L, Alvan G, Lindsten J, Sjoqvist F (1985) A family study of genetic and environmental factors determining polymorphic hydroxylation of debrisoquin. Clin Pharmacol Ther 38: 394

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Anthony, L.B., Boeve, T.J. & Hande, K.R. Cytochrome P-450IID6 phenotyping in cancer patients: debrisoquin and dextromethorphan as probes. Cancer Chemother. Pharmacol. 36, 125–128 (1995). https://doi.org/10.1007/BF00689196

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00689196

Key words

Navigation