Response to "Understanding CYP2D6 and Its Role in Tamoxifen Metabolism".

07:00 EST 1st January 2014 | BioPortfolio

Summary of "Response to "Understanding CYP2D6 and Its Role in Tamoxifen Metabolism"."

In light of the article "Understanding CYP2D6 and Its Role in Tamoxifen Metabolism" (Smith, 2013), we feel it imperative to comment on the recent, unexpected approval by the U.S. Food and Drug Administration (2013) of the selective serotonin reuptake inhibitor paroxetine as a nonhormonal treatment for menopausal hot flashes. Paroxetine is a strong inhibitor of CYP2D6, the same enzyme system that converts tamoxifen to its active form, endoxifen. Thus, women receiving tamoxifen therapy for hormone-positive breast cancer should be informed of the risk of reducing tamoxifen efficacy with concomitant use of paroxetine to treat their tamoxifen-induced hot flashes (Kaplan & Mahon, 2013). National Comprehensive Cancer Network (2013) guidelines currently recommend against coadministration of strong inhibitors of CYP2D6 with tamoxifen. In addition, a systematic, evidence-based review of interventions to manage hot flashes in women with breast cancer and men with prostate cancer found only two agents likely to be effective, the serotonin-norepinephrine reuptake inhibitor venlafaxine, and gabapentin. Paroxetine was among the many interventions ranked evidence not established (Kaplan et al., 2011).


Journal Details

This article was published in the following journal.

Name: Oncology nursing forum
ISSN: 1538-0688
Pages: 12


DeepDyve research library

PubMed Articles [31057 Associated PubMed Articles listed on BioPortfolio]

CYP2D6 pharmacogenetic and oxycodone pharmacokinetic association study in pediatric surgical patients.

Oxycodone is partly metabolized to the active metabolite oxymorphone by hepatic CYP2D6 in the liver. Significant genetic variability in CYP2D6 activity affects oxymorphone formation. This study aimed ...

Comprehensive assessment of cytochromes P450 and transporter genetics with endoxifen concentration during tamoxifen treatment.

Tamoxifen bioactivation to endoxifen is mediated primarily by CYP2D6; however, considerable variability remains unexplained. Our aim was to perform a comprehensive assessment of the effect of genetic ...

First-in-Human Phase I Study of the Tamoxifen Metabolite Z-Endoxifen in Women With Endocrine-Refractory Metastatic Breast Cancer.

Purpose Endoxifen is a tamoxifen metabolite with potent antiestrogenic activity. Patients and Methods We performed a phase I study of oral Z-endoxifen to determine its toxicities, maximum tolerated do...

Understanding tamoxifen adherence in women with breast cancer: A qualitative study.

Non-adherence to tamoxifen is common in breast cancer survivors and is associated with poor clinical outcomes. This study aimed to understand womens' experiences of taking tamoxifen and to identify fa...

Chirality and neuropsychiatric drugs - An update on stereoselective disposition and clinical pharmacokinetics of bupropion.

Bupropion, an antidepressant drug has been approved as a racemate containing equal amounts of R- and S- enantiomers. Recently, the chirality of bupropion has received significant attention in the deli...

Clinical Trials [6483 Associated Clinical Trials listed on BioPortfolio]

A Pilot Study of Varying Doses of Tamoxifen in the Setting of Genetic Polymorphisms of CYP2D6

The investigators plan to examine endoxifen and 4-OH-Tam as a function of the tamoxifen dose in patients with a genetic CYP2D6 polymorphism. The investigators also plan to investigate oth...

Evaluation of the Association Between CYP2D6 Genetic Polymorphisms and the Treatment Effect of Tamoxifen

Primary objectives of this study is to evaluate the effects of CYP2D6 genotypes on time to progression after tamoxifen treatment in pre- or postmenopausal women with metastatic breast canc...

CYP2D6 Genotype on the Clinical Effect of Tamoxifen

The purpose of this study is to investigate the impact of CYP2D6 Genotype on the clinical effects of tamoxifen using with samples from prospective randomized multicenter study(ASTRRA).

Study of Tamoxifen Dose Escalation in Breast Cancer Patients With CYP2D6 Polymorphisms

Tamoxifen is an important drug for the treatment of breast cancer. Used adjuvantly after operation in early breast cancer, tamoxifen reduces annual recurrence rate by half and cancer death...

CYP2D6 Genotyping by AmpliChipTM CYP450 for Tamoxifen-Treated Breast Cancer Patients

The aim of the study is to examine whether tamoxifen-treated Israeli breast cancer patients who are CYP2D6 poor metabolizers (CYP2D6*4/*4 genotype) are at higher cancer relapse risk during...

Medical and Biotech [MESH] Definitions

One of the SELECTIVE ESTROGEN RECEPTOR MODULATORS with tissue-specific activities. Tamoxifen acts as an anti-estrogen (inhibiting agent) in the mammary tissue, but as an estrogen (stimulating agent) in cholesterol metabolism, bone density, and cell proliferation in the ENDOMETRIUM.

Naturally occurring genetic variations associated with drug response (e.g., dosage, extent and rate of metabolic processes). While these variants are not markers for GENETIC PREDISPOSITION TO DISEASE they influence PHARMACOKINETICS and pharmacodynamics and often occur on genes encoding drug metabolism enzymes and transporters (e.g., ANGIOTENSIN CONVERTING ENZYME; CYTOCHROME P-450 CYP2D6).

Drugs and compounds which inhibit or antagonize the biosynthesis or actions of CYTOCHROME P-450 CYP2D6.

Drugs and compounds that induce the synthesis of CYTOCHROME P-450 CYP2D6.

A first generation selective estrogen receptor modulator (SERM). Like TAMOXIFEN, it is an estrogen agonist for bone tissue and cholesterol metabolism but is antagonistic on mammary and uterine tissue.

Quick Search

DeepDyve research library

Relevant Topics

Enzymes are proteins that catalyze (i.e., increase the rates of) chemical reactions. In enzymatic reactions, the molecules at the beginning of the process, called substrates, are converted into different molecules, called products. Almost all chemical re...

Women's Health
Women's Health - key topics include breast cancer, pregnancy, menopause, stroke Follow and track Women's Health News on BioPortfolio: Women's Health News RSS Women'...

Searches Linking to this Article