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伊立替康是治疗胃肠道肿瘤和小细胞肺癌的常用化疗药物,其最常见的不良反应为迟发性腹泻和中性粒细胞减少。不良反应的发生与遗传因素和非遗传因素有关。遗传因素涉及羧酸酯酶、肝脏尿苷二磷酸葡萄糖醛酸转移酶1A和细胞色素P4503A4等多种酶与转运体的基因多态性。患者的年龄、吸烟、合并用药等非遗传因素也可影响机体对伊立替康的敏感性和药物在体内的代谢过程。针对不同基因型患者制定伊立替康的个体化治疗方案,有助于提高临床疗效并降低不良反应发生率。“,”Irinotecan is a chemotherapeutic agent widely used in the treatment of gastrointestinal cancer and small cell lung cancer. The common adverse reactions of irinotecan are delayed onset diarrhea and neutropenia. These adverse reactions are associated with genetic factors and non-genetic factors. Genetic factors include genetic polymorphisms of various enzymes and transporters,such as carboxylesterase,liver uridine diphosphate glucuronosyltransferase 1A,and cytochrome P450 3A4. Non-genetic factors including age,smoking,and drug combination can also affect the susceptibility of irinotecan and metabolism of drugs. Providing an individualized treatment according to different genotypes can improve clinical response of irinotecan and decrease the incidence of adverse reactions.