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Association of radiation-induced normal tissue toxicity with a high genetic risk for rheumatoid arthritis

McWilliam, A.
Marshall, D.
Kerns, S. L.
Barnett, G. C.
Vega, A.
Kapouranis, T.
Aguado Barrera, M. E.
Avuzzi, B.
Azria, D.
Chang-Claude, J.
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Abstract
BACKGROUND: Overlapping genes are involved with rheumatoid arthritis (RA) and DNA repair pathways. Therefore, we hypothesized that patients with a high polygenic risk score for RA will have an increased risk of radiotherapy toxicity given the involvement of DNA repair. METHODS: Primary analysis was performed on 1494 prostate cancer, 483 lung cancer, and 1820 breast cancer patients assessed for development of radiotherapy toxicity in the REQUITE (validating pREdictive models and biomarkers of radiotherapy toxicity to reduce side effects and improve QUalITy of lifE in cancer survivors) study. Validation cohorts were available from the Radiogenomics Consortium. All patients had undergone curative-intent radiotherapy and were assessed prospectively for toxicity. Germline genomic data was available for all patients, allowing a polygenic risk score to be calculated using 101 RA risk variants. Polygenic risk score was analyzed as a continuous variable and with a more than 90th percentile cutoff. Associations with acute and late standardized total average toxicity (STAT) scores and individual toxicity endpoints were analyzed in multivariable models with preselected adjustment variables. RESULTS: Increasing polygenic risk score for RA did not increase the risk of STAT-acute or STAT-late in any cohort. There was an increased risk of late esophagitis in the lung cancer cohort (coefficient = 0.018, P = .01), however this was not validated (P = .79). No individual acute or late toxicity endpoints were statistically significantly associated with polygenic risk score for the prostate or breast cohorts. No statistically significant results were found in the validation cohorts in multivariable models. CONCLUSIONS: Patients with a high genetic risk for RA do not show increased levels of toxicity after radiotherapy suggesting treatment planning does not need to be modified for such patients.
Affiliation
Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom. The Christie NHS Foundation Trust, Manchester, United Kingdom. Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States. Medical College of Wisconsin, Milwaukee, WI, United States. Oncology Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain. Fundación Pública Galega de Medicina Xenómica (FPGMX), Santiago de Compostela, Spain. Biomedical Network on Rare Diseases (CIBERER), Spain. Department of Radiation Oncology, Fondazione Istituto di ricovero e cura a carattere scientifico (IRCCS) Istituto Nazionale dei Tumori, Milan, Italy. Federation Universitaire d'Oncologie Radiothérapie d'Occitanie Méditerranée, Univ Montpellier, INSERM U1194 IRCM, Institut du Cancer Montpellier (ICM), Montpellier, France. German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany. University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Escola de Doutoramento Interacional, Universidade de Santiago de Compostela, Santiago de Compostela, Spain. Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, Cambridge, United Kingdom. Federation Universitaire d'Oncologie Radiothérapie d'Occitanie Méditerranée, Institut du Cancer Du Gard (ICG), CHU Carémeau, Nîmes, France. Hereditary Cancer Genetics Group, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain. Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Spain. KU Leuven, Leuven, Belgium. Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. Leicester Cancer Research Centre, University of Leicester, Leicester, United Kingdom. Maastro Clinic, Maastricht, The Netherlands. Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany. Department of Genetics & Cancer Sciences, University of Leicester, Maastrcht, United Kingdom. Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium. Department of Human Structure and Repair, Ghent University, Ghent, Belgium. Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States. Translational Radiobiology Group, Manchester, United Kingdom.
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2025
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Article
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McWilliam A, Marshall D, Kerns SL, Barnett GC, Vega A, Kapouranis T, et al. Association of radiation-induced normal tissue toxicity with a high genetic risk for rheumatoid arthritis. Journal of the National Cancer Institute. 2025 May 1;117(5):1018-26. PubMed PMID: 39761002. Pubmed Central PMCID: PMC12058264. Epub 2025/01/06. eng.
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