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The Interplay Between CES1 Gene Polymorphisms and Environmental Exposures in Chemotherapy Toxicity in Breast Cancer: CES1 Variants and Environment in Chemo Toxicity
Abstract
Breast cancer remains one of the most prevalent malignancies worldwide, with chemotherapy serving as a cornerstone of treatment despite its substantial toxicity risks. Carboxylesterase 1 (CES1), a critical drug-metabolizing enzyme, plays a central role in the activation and clearance of various chemotherapeutic agents, including capecitabine. Genetic polymorphisms in CES1, together with environmental exposures such as pollutants, diet, and lifestyle factors, contribute to the interindividual variability in chemotherapy metabolism and toxicity profiles. This chapter examines the complex gene–environment interplay influencing treatment outcomes in breast cancer and highlights emerging strategies for integrating genetic and environmental assessments. A deeper understanding of these interactions paves the way for precision oncology approaches that personalize therapy, improve tolerability, and ultimately enhance patient outcomes in breast cancer care.
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