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The comet assay as a tool in human biomonitoring exposure to antineoplastic drugs: a systematic review and meta-analysis

2026-03Artigo científico Acesso aberto
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datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorLadeira, Carina
dc.contributor.authorAzqueta, Amaya
dc.contributor.authorGiovannelli, Lisa
dc.contributor.authorGajski, Goran
dc.contributor.authorGerić, Marko
dc.contributor.authorHaveric, Anja
dc.contributor.authorStopper, Helga
dc.contributor.authorBankoglu, Ezgi Eyluel
dc.contributor.authorCollins, Andrew
dc.contributor.authorMøller, Peter
dc.date.accessioned2026-04-17T07:30:18Z
dc.date.available2026-04-17T07:30:18Z
dc.date.issued2026-03
dc.descriptionThis work was supported by the affiliated institutions, European Regional Development Fund project KK.01.1.1.02.0007 (Rec-IMI), the European Union—Next Generation EU 533–03–23–0006 (BioMolTox), and the International Comet Assay Working Group (ICAWG).
dc.description.abstractAntineoplastic agents are toxic compounds, generally used in the treatment of cancers, which are recognized as carrying a cancer development risk. In this systematic review and meta-analysis of human biomonitoring studies, we have assessed the effects of exposure to antineoplastic drugs on levels of DNA strand breaks in leukocytes, measured by the comet assay. Focusing on the application of the comet assay in human biomonitoring of occupational exposure to antineoplastic agents, we have analyzed 458 original research studies that used this assay, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA-ScR). The systematic review led to 23 studies, of which 20 studies met the criteria for inclusion in the meta-analysis. Using standardized mean difference and 95% confidence interval (CI), the meta-analyses show increased levels of DNA strand breaks in subjects exposed to antineoplastic drugs (1.26, 95% CI: 0.78, 1.73). Results originate mainly from studies on healthcare workers, with only one study in an industrial setting. Subgroup analysis indicates that all studies combined from middle-income countries have a higher effect size (1.77, 95% CI: 1.00, 2.55) than studies from high-income countries (0.49, 95% CI: 0.09, 0.90). This difference between middle- and high-income countries may be attributable in part to differences in exposure levels or exposure assessment. Additionally, sensitivity analysis indicates that studies with moderate/high risk of comet assay measurement bias have higher effect size (2.07, 95% CI: 0.82, 3.31) than studies with low risk of bias (0.73, 95% CI: 0.34, 1.13); and that studies with high risk of exposure misclassification have higher effect size (1.47, 95% CI: 0.89, 2.06) than studies with low/moderate risk (0.13, 955 CI: -0.08, 0.33). Most studies have a low/moderate risk of bias related to the comet assay procedure (15 out of 20 studies), absence of reporting the use of assay controls (1 out of 20 studies), blinded analysis of samples (7 out of 20 studies), and exposure assessment (16 out of 20 studies). In conclusion, this systematic review and meta-analysis show that exposure to antineoplastic drugs is associated with increased levels of DNA strand breaks in human leukocytes.eng
dc.identifier.citationLadeira C, Azqueta A, Giovannelli L, Gajski G, Gerić M, Haveric A, et al. The comet assay as a tool in human biomonitoring exposure to antineoplastic drugs: a systematic review and meta-analysis. Mutat Res Rev Mutat Res. 2026;797:108590.
dc.identifier.doi10.1016/j.mrrev.2026.108590
dc.identifier.issn1383-5742
dc.identifier.urihttp://hdl.handle.net/10400.21/22796
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier BV
dc.relationEuropean Regional Development Fund project KK.01.1.1.02.0007 (Rec-IMI)
dc.relationEuropean Union—Next Generation EU 533–03–23–0006 (BioMolTox)
dc.relation.hasversionhttps://www.sciencedirect.com/science/article/pii/S1383574226000062
dc.relation.ispartofMutation Research - Reviews in Mutation Research
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectAntineoplastics
dc.subjectComet assay
dc.subjectCytotoxics
dc.subjectOccupational exposure
dc.subjectHuman biomonitoring
dc.subjectSystematic review
dc.subjectMeta-analysis
dc.titleThe comet assay as a tool in human biomonitoring exposure to antineoplastic drugs: a systematic review and meta-analysiseng
dc.typejournal article
dcterms.referenceshttps://www.sciencedirect.com/science/article/pii/S1383574226000062#coi0005
dspace.entity.typePublication
oaire.citation.startPage108590
oaire.citation.titleMutation Research - Reviews in Mutation Research
oaire.citation.volume797
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameLadeira
person.givenNameCarina
person.identifier144237
person.identifier.ciencia-id801C-1BBA-1D9E
person.identifier.orcid0000-0001-5588-0074
person.identifier.ridJ-2572-2012
person.identifier.scopus-author-id36463788000
relation.isAuthorOfPublication1aef4b60-4197-436b-84ab-80d31cbaed33
relation.isAuthorOfPublication.latestForDiscovery1aef4b60-4197-436b-84ab-80d31cbaed33

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