1. CYP2D6 Genotype and Adjuvant Tamoxifen: Meta‐Analysis of Heterogeneous Study Populations
- Author
-
Province, MA, Goetz, MP, Brauch, H, Flockhart, DA, Hebert, JM, Whaley, R, Suman, VJ, Schroth, W, Winter, S, Zembutsu, H, Mushiroda, T, Newman, WG, Lee, M‐T M, Ambrosone, CB, Beckmann, MW, Choi, J‐Y, Dieudonné, A‐S, Fasching, PA, Ferraldeschi, R, Gong, L, Haschke‐Becher, E, Howell, A, Jordan, LB, Hamann, U, Kiyotani, K, Krippl, P, Lambrechts, D, Latif, A, Langsenlehner, U, Lorizio, W, Neven, P, Nguyen, AT, Park, B‐W, Purdie, CA, Quinlan, P, Renner, W, Schmidt, M, Schwab, M, Shin, J‐G, Stingl, JC, Wegman, P, Wingren, S, Wu, AHB, Ziv, E, Zirpoli, G, Thompson, AM, Jordan, VC, Nakamura, Y, Altman, RB, Ames, MM, Weinshilboum, RM, Eichelbaum, M, Ingle, JN, Klein, TE, and Consortium, International Tamoxifen Pharmacogenomics
- Subjects
Pharmacology and Pharmaceutical Sciences ,Biomedical and Clinical Sciences ,Breast Cancer ,Women's Health ,Estrogen ,Aging ,Cancer ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Aged ,Antineoplastic Agents ,Hormonal ,Breast Neoplasms ,Cytochrome P-450 CYP2D6 ,Female ,Genetic Variation ,Genotype ,Humans ,Menopause ,Middle Aged ,Pharmacogenetics ,Survival Analysis ,Tamoxifen ,Treatment Outcome ,International Tamoxifen Pharmacogenomics Consortium ,Pharmacology & Pharmacy ,Pharmacology and pharmaceutical sciences - Abstract
The International Tamoxifen Pharmacogenomics Consortium was established to address the controversy regarding cytochrome P450 2D6 (CYP2D6) status and clinical outcomes in tamoxifen therapy. We performed a meta-analysis on data from 4,973 tamoxifen-treated patients (12 globally distributed sites). Using strict eligibility requirements (postmenopausal women with estrogen receptor-positive breast cancer, receiving 20 mg/day tamoxifen for 5 years, criterion 1); CYP2D6 poor metabolizer status was associated with poorer invasive disease-free survival (IDFS: hazard ratio = 1.25; 95% confidence interval = 1.06, 1.47; P = 0.009). However, CYP2D6 status was not statistically significant when tamoxifen duration, menopausal status, and annual follow-up were not specified (criterion 2, n = 2,443; P = 0.25) or when no exclusions were applied (criterion 3, n = 4,935; P = 0.38). Although CYP2D6 is a strong predictor of IDFS using strict inclusion criteria, because the results are not robust to inclusion criteria (these were not defined a priori), prospective studies are necessary to fully establish the value of CYP2D6 genotyping in tamoxifen therapy.
- Published
- 2014