In the worldwide, morbidity and mortality of gastrointestinal tumor ranks first in the forefront of all malignant tumors. Its biological characteristics have a high invasive. After radical surgery, there are about 50% of patients who have recurrence or metastasis, even it is late when they find it. In the past decade, one of the important progresses of pharmaceutical raw materials suppliers’ clinical research is to establish the value of chemotherapy in advanced gastrointestinal cancer patients. Compared with best supportive care, chemotherapy helps prolong survival and improve quality of life.

Since the irinotecan come out in late 1990s, the treatment of advanced gastrointestinal tumors has new breakthroughs. The LV compared with BSC or 5-FU and irinotecan as first-line or second-line treatment failure of 5-FU treatment could significantly improve survival of advanced gastrointestinal tumors, showing good efficacy and survival advantage, but the application subject to the limitations of its possible serious toxicity, the irinotecan dose-limiting toxicity in healthy reduced delayed diarrhea and neutropenia.

Urgent need to explore to be able to predict chemotherapy toxicity indicators used to guide clinical and genetic polymorphisms of which drug metabolism is one of the main factors causing adverse reactions difference between individuals. Irinotecan Kang's main metabolizing enzyme UGT1A1 affect its active product SN-38 and inactivated product SN-38G into each other, resulting in irinotecan Kang toxicity of individual differences, while the UGT1A1 gene polymorphism determines its enzymatic activity high and low. By detecting the variation of specific gene loci irinotecan metabolizing enzyme UGT1A1 activity, research and clinical adverse reactions, especially the relationship of severe delayed diarrhea and neutropenia.In addition, irinotecan price is reasonable.

The UGT1A1 * 28 \ * 1 heterozygous gene polymorphism can increase the risk of patients with diarrhea Ⅲ degree but can not be increased in patients with Ⅲ degree of leukocyte or neutrophil cells to reduce the risk. The UGT1A1 * 6 \ * 1 heterozygous gene polymorphism does not increase the risk of patients with diarrhea Ⅲ degree will not increase in patients with Ⅲ degree WBC or neutrophil cells to reduce the risk. UGT1A1 * 28 polymorphism genotype two groups of patients were recorded to severe toxicity (weeks and the number of treatment cycles), the median of the two groups to severe toxicity time of 9 weeks and 3 weeks, no significant difference seen the UGT1A1 * 28 \ * 1 heterozygous gene polymorphism does not affect the time of severe toxicity for the patients.

In patients with irinotecan chemotherapy, TATA-box gene polymorphism (TA) 6 \ (TA) 7 heterozygous state in the UGT1A1 promoter region can increase the risk for patients to get diarrhea Ⅲ, but it will not increase the risk of Ⅲ white blood cells or neutropenia. The UGT1A1’s first exon 211 of G \ A heterozygous gene polymorphism does not increase the risk for patients to get diarrhea Ⅲ. And it do not increase the Ⅲwhite blood cells or granulocyte cells.Source:http://www.cospcn.com