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J Clin Oncol. 2010 Jun 1;28(16):2768-76. doi: 10.1200/JCO.2009.23.8931. Epub 2010 May 3.

Coprescription of tamoxifen and medications that inhibit CYP2D6.

Author information

  • 1Department of Oncology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.

Erratum in

  • J Clin Oncol. 2010 Jul 20;28(21):3543.

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.

PMID:
20439629
[PubMed - indexed for MEDLINE]
PMCID:
PMC2881853
Free PMC Article

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