Inflammation genes and pain severity in lung cancer patients

9618 Background: While studies suggest that variants in infammation genes explain individual variation in pain severity, these studies only assessed one or a few candidate genes. Given that pain is a complex trait, multiple genes with relatively small effects are likely to influence vulnerability to pain. In this study, we evaluated a comprehensive panel of 59 single nucleotide polymorphisms (SNP) in 37 inflammation genes in newly diagnosed non-Hispanic Caucasian lung cancer patients (n=667) and assessed their association with pain severity. We also assessed the extent to which clinical and demographic factors explain pain severity in this population. Methods: Patients rated their pain “during the past week” on an 11-point numeric scale, (0= ‘no pain’ and 10= ‘pain as bad as you can imagine’) at presentation, prior to initiating cancer therapy. A score > 7/10 was considered to indicate severe pain. Logistic regression analyses were conducted to assess the extent of association between genetic polymorphism and pain severity. All SNPs were genotyped using SNPlex. Results: Results showed that 16% of the sample reported severe pain. As expected, severe pain was more prevalent among those with advanced stage of disease (OR=2.34; 95% CI=1.50–3.65), younger age (OR=0.47; 95%CI=0.30–0.75), depressed mood (OR=3.68; 95%CI=1.96–6.93) and fatigue (OR=3.68; 95% CI=1.96–6.93). Of the 59 SNPs, we initially found SNPS in 6 genes [IKB 3’-UTR(C/T), TNFA -308GA, TNFB Arg13Cys, IL2-330T/G, IL8–251 T/A, COX2 3’-UTR(T/C)] to be significantly associated with severe pain. Controlling for clinical and demographic variables, we found that carriers of CC alleles for COX2 3’-UTR T/C (OR= 3.24; 95% CI=1.12, 9.39) and carriers of TT alleles for IL2-330T/G (OR=1.68; 95%CI=1.04, 2.73) persisted as significant correlates of severe pain. Conclusions: Because genetic polymorphisms are stable markers, understanding the extent to which genetic variability plays a role on cancer-related pain may prove useful in identifying patients at high-risk for pain development and importantly, could help in understanding patients who might benefit most from symptom intervention, and ultimately in developing personalized and more effective pain therapies. No significant financial relationships to disclose.