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de Lara DV, de Melo DO, Kawakami DY, Gonçalves TS, Santos PC. Pharmacogenetic testing-guided treatment for oncology: an overview of reviews. Pharmacogenomics 2022; 23:739-748. [PMID: 36001087 DOI: 10.2217/pgs-2022-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Pharmacogenetics is the relationship between an individual's genetic variations and their response to pharmacological treatment. We conducted an overview of reviews on the use of post-treatment pharmacogenetic testing for oncology, based on clinically relevant gene-drug pairs. We conducted a search on Medline, Embase and Cochrane Library, from their inception to 18 June 2020. We selected six eligible systematic reviews. The most studied drug categories were estrogen agonists/antagonists and fluoropyrimidines associated with cytochrome P450 and dihydropyrimidine dehydrogenase genes (CYP2D6 and DPYD), but many studies were classified as being of critically low or low quality. There is a need for more high-quality primary studies and systematic reviews that assess the risk of bias, with consistent definitions of clinical outcomes to consider the benefits of pharmacogenetic testing for oncology.
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Affiliation(s)
- Danilo Vieira de Lara
- Department of Pharmacology, Escola Paulista de Medicina, Universidade Federal de São Paulo, EPM - Unifesp, São Paulo, 04044-020, Brazil
| | - Daniela Oliveira de Melo
- Institute of Environmental Sciences, Chemistry & Pharmaceuticals, Department of Pharmaceutical Sciences, Universidade Federal de São Paulo, Diadema, São Paulo, 09913-030, Brazil
| | - Daniele Y Kawakami
- Institute of Environmental Sciences, Chemistry & Pharmaceuticals, Department of Pharmaceutical Sciences, Universidade Federal de São Paulo, Diadema, São Paulo, 09913-030, Brazil
| | - Thuane S Gonçalves
- Department of Pharmacology, Escola Paulista de Medicina, Universidade Federal de São Paulo, EPM - Unifesp, São Paulo, 04044-020, Brazil
| | - Paulo Cjl Santos
- Department of Pharmacology, Escola Paulista de Medicina, Universidade Federal de São Paulo, EPM - Unifesp, São Paulo, 04044-020, Brazil
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Guchelaar HJ, Sanchez-Spitman A, Dezentjé V, Böhringer S, Swen J, Neven P, Gelderblom H. Reply to C.L. Braal et al, H. Brauch et al, and M.P. Goetz et al. J Clin Oncol 2019; 37:1984-1985. [DOI: 10.1200/jco.19.00932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Henk-Jan Guchelaar
- Henk-Jan Guchelaar, PharmD, PhD and Anabel Sanchez-Spitman, PharmD, Leiden University Medical Center, Leiden, the Netherlands; Vincent Dezentjé, MD, PhD, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, the Netherlands; Stefan Böhringer, PhD, MD and Jesse Swen, PharmD, PhD, Leiden University Medical Center, Leiden, the Netherlands; Patrick Neven, MD, PhD, University Hospitals Leuven, Leuven, Belgium; and Hans Gelderblom, MD, PhD, Leiden University Medical Center, Leiden, the Netherlands
| | - Anabel Sanchez-Spitman
- Henk-Jan Guchelaar, PharmD, PhD and Anabel Sanchez-Spitman, PharmD, Leiden University Medical Center, Leiden, the Netherlands; Vincent Dezentjé, MD, PhD, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, the Netherlands; Stefan Böhringer, PhD, MD and Jesse Swen, PharmD, PhD, Leiden University Medical Center, Leiden, the Netherlands; Patrick Neven, MD, PhD, University Hospitals Leuven, Leuven, Belgium; and Hans Gelderblom, MD, PhD, Leiden University Medical Center, Leiden, the Netherlands
| | - Vincent Dezentjé
- Henk-Jan Guchelaar, PharmD, PhD and Anabel Sanchez-Spitman, PharmD, Leiden University Medical Center, Leiden, the Netherlands; Vincent Dezentjé, MD, PhD, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, the Netherlands; Stefan Böhringer, PhD, MD and Jesse Swen, PharmD, PhD, Leiden University Medical Center, Leiden, the Netherlands; Patrick Neven, MD, PhD, University Hospitals Leuven, Leuven, Belgium; and Hans Gelderblom, MD, PhD, Leiden University Medical Center, Leiden, the Netherlands
| | - Stefan Böhringer
- Henk-Jan Guchelaar, PharmD, PhD and Anabel Sanchez-Spitman, PharmD, Leiden University Medical Center, Leiden, the Netherlands; Vincent Dezentjé, MD, PhD, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, the Netherlands; Stefan Böhringer, PhD, MD and Jesse Swen, PharmD, PhD, Leiden University Medical Center, Leiden, the Netherlands; Patrick Neven, MD, PhD, University Hospitals Leuven, Leuven, Belgium; and Hans Gelderblom, MD, PhD, Leiden University Medical Center, Leiden, the Netherlands
| | - Jesse Swen
- Henk-Jan Guchelaar, PharmD, PhD and Anabel Sanchez-Spitman, PharmD, Leiden University Medical Center, Leiden, the Netherlands; Vincent Dezentjé, MD, PhD, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, the Netherlands; Stefan Böhringer, PhD, MD and Jesse Swen, PharmD, PhD, Leiden University Medical Center, Leiden, the Netherlands; Patrick Neven, MD, PhD, University Hospitals Leuven, Leuven, Belgium; and Hans Gelderblom, MD, PhD, Leiden University Medical Center, Leiden, the Netherlands
| | - Patrick Neven
- Henk-Jan Guchelaar, PharmD, PhD and Anabel Sanchez-Spitman, PharmD, Leiden University Medical Center, Leiden, the Netherlands; Vincent Dezentjé, MD, PhD, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, the Netherlands; Stefan Böhringer, PhD, MD and Jesse Swen, PharmD, PhD, Leiden University Medical Center, Leiden, the Netherlands; Patrick Neven, MD, PhD, University Hospitals Leuven, Leuven, Belgium; and Hans Gelderblom, MD, PhD, Leiden University Medical Center, Leiden, the Netherlands
| | - Hans Gelderblom
- Henk-Jan Guchelaar, PharmD, PhD and Anabel Sanchez-Spitman, PharmD, Leiden University Medical Center, Leiden, the Netherlands; Vincent Dezentjé, MD, PhD, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, the Netherlands; Stefan Böhringer, PhD, MD and Jesse Swen, PharmD, PhD, Leiden University Medical Center, Leiden, the Netherlands; Patrick Neven, MD, PhD, University Hospitals Leuven, Leuven, Belgium; and Hans Gelderblom, MD, PhD, Leiden University Medical Center, Leiden, the Netherlands
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Brauch H, Schroth W, Mürdter T, Schwab M. Tamoxifen Pharmacogenetics and Metabolism: The Same Is Not the Same. J Clin Oncol 2019; 37:1981-1982. [PMID: 31211600 DOI: 10.1200/jco.19.00507] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Hiltrud Brauch
- Hiltrud Brauch, PhD, Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, University of Tübingen, Tübingen, Germany, and German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany; Werner Schroth, PhD and Thomas Mürdter, PhD, Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, and University of Tübingen, Tübingen, Germany; and Matthias Schwab, MD, Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, University of Tübingen, Tübingen, Germany, and German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Werner Schroth
- Hiltrud Brauch, PhD, Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, University of Tübingen, Tübingen, Germany, and German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany; Werner Schroth, PhD and Thomas Mürdter, PhD, Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, and University of Tübingen, Tübingen, Germany; and Matthias Schwab, MD, Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, University of Tübingen, Tübingen, Germany, and German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Thomas Mürdter
- Hiltrud Brauch, PhD, Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, University of Tübingen, Tübingen, Germany, and German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany; Werner Schroth, PhD and Thomas Mürdter, PhD, Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, and University of Tübingen, Tübingen, Germany; and Matthias Schwab, MD, Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, University of Tübingen, Tübingen, Germany, and German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias Schwab
- Hiltrud Brauch, PhD, Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, University of Tübingen, Tübingen, Germany, and German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany; Werner Schroth, PhD and Thomas Mürdter, PhD, Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, and University of Tübingen, Tübingen, Germany; and Matthias Schwab, MD, Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany, University of Tübingen, Tübingen, Germany, and German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
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Martínez Guisado A, Sánchez Muñoz A, de la Cabeza Lomas Garrido M, Ruíz Borrego M, Bayo Calero J, de Toro Salas R, González Mancha R, de la Haba Rodríguez J, Alba Conejo E. Initialization of adjuvant hormonal treatment for breast cancer. Adv Ther 2011; 28 Suppl 6:66-84. [PMID: 21922396 DOI: 10.1007/s12325-011-0039-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Indexed: 12/21/2022]
Abstract
The introduction of aromatase inhibitors (AI) has resulted in practice change approaches in the treatment of early breast cancer. In this paper, we analyze the most relevant studies including the ATAC, BIG 1-98, TEAM, MA-17, NSABP B-33, and ABSCG-6 studies. Postmenopausal patients with hormone receptor-positive early breast cancer should be treated with AI for 5 years. For patients who have been initiated with tamoxifen (TAM), switching to an AI to complete 5 years of treatment is also recommended. The results of the extended adjuvant therapy studies recommend the use of an AI (anastrozole, letrozole, or exemestane) after the completion of standard TAM treatment. With regards to premenopausal women, TAM is the recommended adjuvant hormonal treatment for pre- and perimenopausal women. There is no indication for the use of AI in these subgroups of patients. Finally, determination of CYP 2D6 polymorphisms could be considered when choosing the best adjuvant hormonal treatment option.
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Irvin W, Muss HB, Mayer DK. Symptom management in metastatic breast cancer. Oncologist 2011; 16:1203-14. [PMID: 21880861 PMCID: PMC3228166 DOI: 10.1634/theoncologist.2011-0159] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 07/12/2011] [Indexed: 11/17/2022] Open
Abstract
Approximately 40,000 women die as a result of breast cancer each year and many more live with advanced disease. When breast cancer recurs, the goals of treatment often shift from one of cure to controlling the disease for as long as possible while palliating symptoms interfering with the patient's functional status and quality of life. This requires ongoing discussions with the patient and family about the goals of care. Many symptoms depend on the site of metastasis, with bone being the most frequent, and commonly occur with fatigue, depression, insomnia, and pain. The purpose of this paper is to identify and provide an overview of the management of the most common symptoms in patients with breast cancer metastases.
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Affiliation(s)
- William Irvin
- Lineberger Comprehensive Cancer Center; University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hyman B. Muss
- Lineberger Comprehensive Cancer Center; University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, USA
| | - Deborah K. Mayer
- Lineberger Comprehensive Cancer Center; University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, USA
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Irvin WJ, Walko CM, Weck KE, Ibrahim JG, Chiu WK, Dees EC, Moore SG, Olajide OA, Graham ML, Canale ST, Raab RE, Corso SW, Peppercorn JM, Anderson SM, Friedman KJ, Ogburn ET, Desta Z, Flockhart DA, McLeod HL, Evans JP, Carey LA. Genotype-guided tamoxifen dosing increases active metabolite exposure in women with reduced CYP2D6 metabolism: a multicenter study. J Clin Oncol 2011; 29:3232-9. [PMID: 21768473 DOI: 10.1200/jco.2010.31.4427] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE We examined the feasibility of using CYP2D6 genotyping to determine optimal tamoxifen dose and investigated whether the key active tamoxifen metabolite, endoxifen, could be increased by genotype-guided tamoxifen dosing in patients with intermediate CYP2D6 metabolism. PATIENTS AND METHODS One hundred nineteen patients on tamoxifen 20 mg daily ≥ 4 months and not on any strong CYP2D6 inhibiting medications were assayed for CYP2D6 genotype and plasma tamoxifen metabolite concentrations. Patients found to be CYP2D6 extensive metabolizers (EM) remained on 20 mg and those found to be intermediate (IM) or poor (PM) metabolizers were increased to 40 mg daily. Eighty-nine evaluable patients had tamoxifen metabolite measurements repeated 4 months later. RESULTS As expected, the median baseline endoxifen concentration was higher in EM (34.3 ng/mL) compared with either IM (18.5 ng/mL; P = .0045) or PM (4.2 ng/mL; P < .001). When the dose was increased from 20 mg to 40 mg in IM and PM patients, the endoxifen concentration rose significantly; in IM there was a median intrapatient change from baseline of +7.6 ng/mL (-0.6 to 23.9; P < .001), and in PM there was a change of +6.1 ng/mL (2.6 to 12.5; P = .020). After the dose increase, there was no longer a significant difference in endoxifen concentrations between EM and IM patients (P = .84); however, the PM endoxifen concentration was still significantly lower. CONCLUSION This study demonstrates the feasibility of genotype-driven tamoxifen dosing and demonstrates that doubling the tamoxifen dose can increase endoxifen concentrations in IM and PM patients.
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Affiliation(s)
- William J Irvin
- University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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Burstein HJ, Prestrud AA, Seidenfeld J, Anderson H, Buchholz TA, Davidson NE, Gelmon KE, Giordano SH, Hudis CA, Malin J, Mamounas EP, Rowden D, Solky AJ, Sowers MR, Stearns V, Winer EP, Somerfield MR, Griggs JJ. American Society of Clinical Oncology clinical practice guideline: update on adjuvant endocrine therapy for women with hormone receptor-positive breast cancer. J Clin Oncol 2010; 28:3784-96. [PMID: 20625130 PMCID: PMC5569672 DOI: 10.1200/jco.2009.26.3756] [Citation(s) in RCA: 547] [Impact Index Per Article: 39.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Accepted: 05/20/2010] [Indexed: 01/03/2023] Open
Abstract
PURPOSE To develop evidence-based guidelines, based on a systematic review, for endocrine therapy for postmenopausal women with hormone receptor-positive breast cancer. METHODS A literature search identified relevant randomized trials. Databases searched included MEDLINE, PREMEDLINE, the Cochrane Collaboration Library, and those for the Annual Meetings of the American Society of Clinical Oncology (ASCO) and the San Antonio Breast Cancer Symposium (SABCS). The primary outcomes of interest were disease-free survival, overall survival, and time to contralateral breast cancer. Secondary outcomes included adverse events and quality of life. An expert panel reviewed the literature, especially 12 major trials, and developed updated recommendations. RESULTS An adjuvant treatment strategy incorporating an aromatase inhibitor (AI) as primary (initial endocrine therapy), sequential (using both tamoxifen and an AI in either order), or extended (AI after 5 years of tamoxifen) therapy reduces the risk of breast cancer recurrence compared with 5 years of tamoxifen alone. Data suggest that including an AI as primary monotherapy or as sequential treatment after 2 to 3 years of tamoxifen yields similar outcomes. Tamoxifen and AIs differ in their adverse effect profiles, and these differences may inform treatment preferences. CONCLUSION The Update Committee recommends that postmenopausal women with hormone receptor-positive breast cancer consider incorporating AI therapy at some point during adjuvant treatment, either as up-front therapy or as sequential treatment after tamoxifen. The optimal timing and duration of endocrine treatment remain unresolved. The Update Committee supports careful consideration of adverse effect profiles and patient preferences in deciding whether and when to incorporate AI therapy.
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Sideras K, Ingle JN, Ames MM, Loprinzi CL, Mrazek DP, Black JL, Weinshilboum RM, Hawse JR, Spelsberg TC, Goetz MP. Coprescription of tamoxifen and medications that inhibit CYP2D6. J Clin Oncol 2010; 28:2768-76. [PMID: 20439629 PMCID: PMC2881853 DOI: 10.1200/jco.2009.23.8931] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Accepted: 11/18/2009] [Indexed: 12/14/2022] Open
Abstract
Evidence has emerged that the clinical benefit of tamoxifen is related to the functional status of the hepatic metabolizing enzyme cytochrome P450 2D6 (CYP2D6). CYP2D6 is the key enzyme responsible for the generation of the potent tamoxifen metabolite, endoxifen. Multiple studies have examined the relationship of CYP2D6 status to breast cancer outcomes in tamoxifen-treated women; the majority of studies demonstrated that women with impaired CYP2D6 metabolism have lower endoxifen concentrations and a greater risk of breast cancer recurrence. As a result, practitioners must be aware that some of the most commonly prescribed medications coadministered with tamoxifen interfere with CYP2D6 function, thereby reducing endoxifen concentrations and potentially increasing the risk of breast cancer recurrence. After reviewing the published data regarding tamoxifen metabolism and the evidence relating CYP2D6 status to breast cancer outcomes in tamoxifen-treated patients, we are providing a guide for the use of medications that inhibit CYP2D6 in patients administered tamoxifen.
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Affiliation(s)
- Kostandinos Sideras
- From the Departments of Oncology, Molecular Pharmacology and Experimental Therapeutics, Psychiatry, and Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN
| | - James N. Ingle
- From the Departments of Oncology, Molecular Pharmacology and Experimental Therapeutics, Psychiatry, and Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN
| | - Matthew M. Ames
- From the Departments of Oncology, Molecular Pharmacology and Experimental Therapeutics, Psychiatry, and Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN
| | - Charles L. Loprinzi
- From the Departments of Oncology, Molecular Pharmacology and Experimental Therapeutics, Psychiatry, and Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN
| | - David P. Mrazek
- From the Departments of Oncology, Molecular Pharmacology and Experimental Therapeutics, Psychiatry, and Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN
| | - John L. Black
- From the Departments of Oncology, Molecular Pharmacology and Experimental Therapeutics, Psychiatry, and Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN
| | - Richard M. Weinshilboum
- From the Departments of Oncology, Molecular Pharmacology and Experimental Therapeutics, Psychiatry, and Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN
| | - John R. Hawse
- From the Departments of Oncology, Molecular Pharmacology and Experimental Therapeutics, Psychiatry, and Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN
| | - Thomas C. Spelsberg
- From the Departments of Oncology, Molecular Pharmacology and Experimental Therapeutics, Psychiatry, and Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN
| | - Matthew P. Goetz
- From the Departments of Oncology, Molecular Pharmacology and Experimental Therapeutics, Psychiatry, and Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN
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Ferraldeschi R, Newman WG. The Impact of CYP2D6 Genotyping on Tamoxifen Treatment. Pharmaceuticals (Basel) 2010; 3:1122-1138. [PMID: 27713292 PMCID: PMC4034025 DOI: 10.3390/ph3041122] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Revised: 03/12/2010] [Accepted: 04/09/2010] [Indexed: 12/11/2022] Open
Abstract
Tamoxifen remains a cornerstone of treatment for patients with oestrogen-receptor-positive breast cancer. Tamoxifen efficacy depends on the biotransformation, predominantly via the cytochrome P450 2D6 (CYP2D6) isoform, to the active metabolite endoxifen. Both genetic and environmental (drug-induced) factors may alter CYP2D6 enzyme activity directly affecting the concentrations of active tamoxifen metabolites. Several studies suggest that germline genetic variants in CYP2D6 influence the clinical outcomes of patients treated with adjuvant tamoxifen. Here, we review the existing data relating CYP2D6 genotypes to tamoxifen efficacy.
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Affiliation(s)
- Roberta Ferraldeschi
- Department of Medical Oncology, Christie Hospital NHS Trust, Wilmslow Road, Manchester M20 4BX, UK.
- Genetic Medicine, St Mary's Hospital, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Oxford Road, Manchester, M13 9WL, UK.
| | - William G Newman
- Genetic Medicine, St Mary's Hospital, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Oxford Road, Manchester, M13 9WL, UK.
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Dezentjé VO, Guchelaar HJ, Nortier JW, van de Velde CJ, Gelderblom H. Clinical Implications of CYP2D6 Genotyping in Tamoxifen Treatment for Breast Cancer. Clin Cancer Res 2008; 15:15-21. [DOI: 10.1158/1078-0432.ccr-08-2006] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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