Jeanine Marie Nardin, Werner Schroth, Thais Abreu Almeida, Thomas Mürdter, Solane Picolotto, Evelyn Castillo Lima Vendramini, Reiner Hoppe, Jenifer Primon Kogin, Diandra Miqueleto, Silvia Dark Robaskievicz deMoraes, Matthias Schwab, Roberto Flavio Pecoits‐Filho, Hiltrud Brauch, and José Claudio Casali‐da‐Rocha
Tamoxifen efficacy in breast cancer is suspected to depend on adherence and intact drug metabolism. We evaluated the role of adherence behavior and pharmacogenetics on the formation rate of (Z)‐endoxifen. In 192 Brazilian patients, we assessed plasma levels of tamoxifen and its metabolites at 3, 6, and 12 months of treatment (liquid‐chromatography tandem mass spectrometry), adherence behavior (Morisky, Green, and Levine medication adherence scale), and cytochrome P450 2D6 (CYP2D6) and other pharmacogene polymorphisms (matrix‐assisted laser‐desorption‐ionization time of flight) mass spectrometry, real‐time polymerase chain reaction). Adherence explained 47% of the variability of tamoxifen plasma concentrations (P