He et al reported the implications of CYP2D6 genotype for a patient being treated with tamoxifen. The authors are from Karolinska Institutet and South General Hospital Stockholm in Sweden.
Patient selection: breast cancer treated with tamoxifen
Parameters:
(1) CYP2D6 genotype
Outcomes:
(1) 6-month discontinuation rate
(2) breast cancer specific mortality
CYP2D6 Genotype
Discontinuation Rate
Hazard Ratio for Cancer-Specific Mortality
poor
7.1%
2.6
intermediate
7.6%
1.5
normal
6.7%
1
ultrarapid
18.8%
4.5
Assessment:
(1) Ultrarapid metabolizers have a higher discontinuation rate and cancer-specific mortality. Discontinuation is related to bothersome side effects which have not responded to symptom-relieving drugs.
(2) Poor metabolizers have an increase in cancer-specific mortality.
(3) Starting or stopping a drug that affects CYP2D6 can negatively impact the patient.
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