Decoding the Genetic Landscape of Postoperative Nausea and Vomiting in Cancer Surgery: A New Frontier in Personalized...

Postoperative nausea and vomiting (PONV) is a common complication following surgery, especially among cancer patients. It affects comfort, extends hospital stays, and increases healthcare costs. Advances in genomic research present an opportunity to explore genetic predispositions to PONV, potentially enabling targeted interventions and improved management strategies. This review consolidates findings from genome-wide association studies (GWAS) to identify genetic links to PONV in cancer patients and evaluate their implications for personalized medicine. A thorough search of databases such as PubMed, Scopus, and Web of Science identified GWAS studies on genetic predispositions to PONV in cancer surgery patients up to August 25, 2024. Studies were selected based on inclusion criteria that required reporting genetic associations with PONV, and the findings were analyzed for commonalities and discrepancies. Significant P-values (10^ - 6 to 10^ - 9) were found for multiple SNPs linked to PONV susceptibility. Specifically, rs2776262 (chromosome 21, LOC100506403) showed a P-value of 8.533 × 10^-9 with an odds ratio (OR) of 2.00. The SNP rs12609817 (chromosome 19, ZNF845) had a P-value of 1.055 × 10⁻⁹ and an OR of 4.00, indicating a strong gene expression impact. Additionally, rs921634 (chromosome 7, PKD1L1) had a P-value of 1.393 × 10⁻⁹ and an OR of 9.00, suggesting a significant association with polycystic kidney disease. Protective SNPs such as rs1927382 in FGF14 and rs1333114 in PTPRD were also identified, highlighting risk mitigation opportunities. GWAS studies have identified key SNPs associated with PONV in cancer surgery, including ZNF845 rs12609817, PKD1L1 rs921634, and CLDN14 rs2071049, as well as protective variants like FGF14 rs1927382 and PTPRD rs1333114. These insights advance our understanding of the genetic factors that influence PONV risk, supporting better prediction and management strategies. This research lays the groundwork for personalized treatments to improve patient outcomes in the perioperative setting. Further exploration of these SNPs and their biological mechanisms could enhance PONV prevention strategies for cancer surgery patients.