Tamoxifen can be involved in DDIs either as a victim or as a 三苯氧胺可以参与药品交互作用无论是作为受害者或作为.pptVIP

Tamoxifen and CYP2C19 CYP2C19*17 A study suggests that this may be an UM phenotype Patients with tamoxifen, there are reduced breast cancer recurrences and prolonged relapse-free time and event-free survival rates (23) Another study found that carriers of CYP2C19*17 allele had less frequent recurrences following tamoxifen when compared with non CYP2C19*17 carriers(24) Hoskins 2010 FDA Recommendations In October 2006, the FDA recommended that the tamoxifen prescribing information be updated to include information about CYP2D6 genotypes, CYP2D6 genotyping tests, and the potential relationship between CYP2D6 genotype and clinical outcome. Members of the Endocrinologic and Metabolic Drugs Advisory Committee have not reached a consensus as to whether testing should be recommended or considered as an option. Why Should Patients Taking Tamoxifen Have A Genotype Screening For CYP2D6 and CYP2C19*17? May help to determine: effectiveness of tamoxifen 35% of women with advanced ER positive cancer do not respond to tamoxifen(17) Genetic variation- CYP2D6 PMs (18) _ Genetic variation-CYP2C19*17 have better outcomes - Genetic variation-CYP2D6 UM may have better outcomes Alternative to monitoring initial plasma levels Steady-state metabolite concentrations are not reached until after a month of continuous therapy(20) Genotyping can rapidly determine metabolizer type toxicity CYP2D6 UMs may lead to excessive endoxifen- drug interactions Different types of metabolizers may be more or less affected by taking CYP2D6 inhibitors concomitantly ; e.g., CYP2D6 IMs References Jordan VC (2006). Tamoxifen (ICI46,474) as a targeted therapy to treat and prevent breast cancer. Br J Pharmacol 147 (Suppl 1): S269–76. PMID:/drugsatfda_docs/label/2003/021055s002lbl.pdf /cancertopics/factsheet/Therapy/tamoxifen Neubauer H, Clare SE, Wozny W, Schwall GP, Poznanovic S, Stegmann W, Vogel U, Sotlar K, Wallwiener D, Kurek R, Fehm T, Cahill MA. Breast cancer proteomics rev