Coprescription of tamoxifen and medications that inhibit CYP2D6

Kostandinos Sideras, James N. Ingle, Matthew M. Ames, Charles Lawrence Loprinzi, David P. Mrazek, John L. Black, Richard M Weinshilboum, John R Hawse, Thomas C. Spelsberg, Matthew Philip Goetz

Research output: Contribution to journalArticle

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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.

Original languageEnglish (US)
Pages (from-to)2768-2776
Number of pages9
JournalJournal of Clinical Oncology
Volume28
Issue number16
DOIs
StatePublished - Jun 1 2010

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Cytochrome P-450 CYP2D6
Tamoxifen
Breast Neoplasms
Recurrence
Enzymes
Liver

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Coprescription of tamoxifen and medications that inhibit CYP2D6. / Sideras, Kostandinos; Ingle, James N.; Ames, Matthew M.; Loprinzi, Charles Lawrence; Mrazek, David P.; Black, John L.; Weinshilboum, Richard M; Hawse, John R; Spelsberg, Thomas C.; Goetz, Matthew Philip.

In: Journal of Clinical Oncology, Vol. 28, No. 16, 01.06.2010, p. 2768-2776.

Research output: Contribution to journalArticle

Sideras, Kostandinos ; Ingle, James N. ; Ames, Matthew M. ; Loprinzi, Charles Lawrence ; Mrazek, David P. ; Black, John L. ; Weinshilboum, Richard M ; Hawse, John R ; Spelsberg, Thomas C. ; Goetz, Matthew Philip. / Coprescription of tamoxifen and medications that inhibit CYP2D6. In: Journal of Clinical Oncology. 2010 ; Vol. 28, No. 16. pp. 2768-2776.
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