The clinical effectiveness and cost-effectiveness of genotyping for CYP2D6 for the management of women with breast cancer treated with tamoxifen: a systematic review.
Authors
Fleeman, NMartin Saborido, C
Payne, K
Boland, A
Dickson, R
Dundar, Y
Fernández Santander, A
Howell, Sacha J
Newman, W
Oyee, J
Walley, T
Affiliation
Liverpool Reviews and Implementation Group (LRiG), University of Liverpool, Liverpool, UK.Issue Date
2011-09
Metadata
Show full item recordAbstract
Breast cancer is the most common cancer affecting women in the UK. Tamoxifen (TAM) is considered as the standard of care for many women with oestrogen receptor positive breast cancer. However, wide variability in the response of individuals to drugs at the same doses may occur, which may be a result of interindividual genetic differences (pharmacogenetics). TAM is known to be metabolised to its active metabolites N-desmethyl TAM and 4-hydroxytamoxifen by a number of CYP450 enzymes, including CYP2D6, CYP3A4, CYP2C9, CYP2C19 and CYP2B6. N-desmethyl TAM is further metabolised to endoxifen by CYP2D6. Endoxifen, which is also formed via the action of CYP2D6, is 30- to 100-fold more potent than TAM in suppressing oestrogen-dependent cell proliferation, and is considered an entity responsible for significant pharmacological effects of TAM. Thus, an association between the cytochrome P450 2D6 (CYP2D6) genotype and phenotype (expected drug effects) is believed to exist and it has been postulated that CYP2D6 testing may play a role in optimising an individual's adjuvant hormonal treatment.Citation
The clinical effectiveness and cost-effectiveness of genotyping for CYP2D6 for the management of women with breast cancer treated with tamoxifen: a systematic review. 2011, 15 (33):1-102 Health Technol AssessJournal
Health Technology AssessmentDOI
10.3310/hta15330PubMed ID
21906462Type
ArticleLanguage
enISSN
1366-5278ae974a485f413a2113503eed53cd6c53
10.3310/hta15330
Scopus Count
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