CYP2D6 as a treatment decision aid for ER-positive non-metastatic breast cancer patients: a systematic review with accompanying clinical practice guidelines.

Drögemöller, Britt I; Wright, Galen E B; Shih, Joanne; Monzon, Jose G; Gelmon, Karen A; Ross, Colin J D; Amstutz, Ursula; Carleton, Bruce C (2019). CYP2D6 as a treatment decision aid for ER-positive non-metastatic breast cancer patients: a systematic review with accompanying clinical practice guidelines. Breast cancer research and treatment, 173(3), pp. 521-532. Springer 10.1007/s10549-018-5027-0

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PURPOSE Tamoxifen is one of the principal treatments for estrogen receptor (ER)-positive breast cancer. Unfortunately, between 30 and 50% of patients receiving this hormonal therapy relapse. Since CYP2D6 genetic variants have been reported to play an important role in survival outcomes after treatment with tamoxifen, this study sought to summarize and critically appraise the available scientific evidence on this topic. METHODS A systematic literature review was conducted to identify studies investigating associations between CYP2D6 genetic variation and survival outcomes after tamoxifen treatment. Critical appraisal of the retrieved scientific evidence was performed, and recommendations were developed for CYP2D6 genetic testing in the context of tamoxifen therapy. RESULTS Although conflicting literature exists, the majority of the current evidence points toward CYP2D6 genetic variation affecting survival outcomes after tamoxifen treatment. Of note, review of the CYP2D6 genotyping assays used in each of the studies revealed the importance of comprehensive genotyping strategies to accurately predict CYP2D6 metabolizer phenotypes. CONCLUSIONS AND RECOMMENDATIONS Critical appraisal of the literature provided evidence for the value of comprehensive CYP2D6 genotyping panels in guiding treatment decisions for non-metastatic ER-positive breast cancer patients. Based on this information, it is recommended that alternatives to standard tamoxifen treatments may be considered in CYP2D6 poor or intermediate metabolizers.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry

UniBE Contributor:

Amstutz, Ursula

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0167-6806

Publisher:

Springer

Language:

English

Submitter:

Marie-Christine Müller

Date Deposited:

16 Apr 2019 15:45

Last Modified:

23 Oct 2019 03:33

Publisher DOI:

10.1007/s10549-018-5027-0

PubMed ID:

30411242

Uncontrolled Keywords:

CYP2D6 Clinical practice guidelines Pharmacogenomics Systematic review Tamoxifen

BORIS DOI:

10.7892/boris.125808

URI:

https://boris.unibe.ch/id/eprint/125808

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