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CYP2D6 Genotype and Adjuvant Tamoxifen: Meta-Analysis of Heterogeneous Study Populations

Open access
Province, M A, Goetz, M P, Brauch, H, Flockhart, D A, Hebert, J M, Whaley, R, Suman, V J, Schroth, W, Winter, S, Zembutsu, H, Mushiroda, T, Newman, W G, Lee, M-T M, Ambrosone, C B, Beckmann, M W, Choi, J-Y, Dieudonné, A-S, Fasching, P A, Ferraldeschi, R, Gong, L, Haschke-Becher, E, Howell, A, Jordan, L B, Hamann, U, Kiyotani, K, Krippl, P, Lambrechts, D, Latif, A, Langsenlehner, U, Lorizio, W, Neven, P, Nguyen, A T, Park, B-W, Purdie, C A, Quinlan, P, Renner, W, Schmidt, M, Schwab, M, Shin, J-G, Stingl, J C, Wegman, P, Wingren, S, Wu, A H B, Ziv, E, Zirpoli, G, Thompson, A M, Jordan, V C, Nakamura, Y, Altman, R B, Ames, M M, Weinshilboum, R M, Eichelbaum, M, Ingle, J N, Klein, T E·2014·Clinical Pharmacology & Therapeutics

Abstract

The International Tamoxifen Pharmacogenomics Consortium was established to address the controversy regarding cytochrome P450 2D6 (CYP2D6) status and clinical outcomes in tamoxifen therapy. We performed a meta-analysis on data from 4,973 tamoxifen-treated patients (12 globally distributed sites). Using strict eligibility requirements (postmenopausal women with estrogen receptor-positive breast cancer, receiving 20 mg/day tamoxifen for 5 years, criterion 1); CYP2D6 poor metabolizer status was associated with poorer invasive disease-free survival (IDFS: hazard ratio = 1.25; 95% confidence interval = 1.06, 1.47; P = 0.009). However, CYP2D6 status was not statistically significant when tamoxifen duration, menopausal status, and annual follow-up were not specified (criterion 2, n = 2,443; P = 0.25) or when no exclusions were applied (criterion 3, n = 4,935; P = 0.38). Although CYP2D6 is a strong predictor of IDFS using strict inclusion criteria, because the results are not robust to inclusion criteria (these were not defined a priori), prospective studies are necessary to fully establish the value of CYP2D6 genotyping in tamoxifen therapy.

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Authors
Province, M. A., Goetz, M. P., Brauch, H., Flockhart, D. A., Hebert, J. M., Whaley, R., Suman, V. J., Schroth, W., Winter, S., Zembutsu, H., Mushiroda, T., Newman, W. G., Lee, M.-T. M., Ambrosone, C. B., Beckmann, M. W., Choi, J.-Y., Dieudonné, A.-S., Fasching, P. A., Ferraldeschi, R., Gong, L., Haschke-Becher, E., Howell, A., Jordan, L. B., Hamann, U., Kiyotani, K., Krippl, P., Lambrechts, D., Latif, A., Langsenlehner, U., Lorizio, W., Neven, P., Nguyen, A. T., Park, B.-W., Purdie, C. A., Quinlan, P., Renner, W., Schmidt, M., Schwab, M., Shin, J.-G., Stingl, J. C., Wegman, P., Wingren, S., Wu, A. H. B., Ziv, E., Zirpoli, G., Thompson, A. M., Jordan, V. C., Nakamura, Y., Altman, R. B., Ames, M. M., Weinshilboum, R. M., Eichelbaum, M., Ingle, J. N., & Klein, T. E.
Venue
Clinical Pharmacology & Therapeutics
Publisher
Wiley
Published
2013-09-23
Volume
95
Issue
2
Pages
216-227
ISSN
  • 0009-9236 (ISSN-L)
  • 1532-6535
OpenAlex
W2082048952
Cited by
175
References
0
FWCI
7.75
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: CYP2D6 Genotype and Adjuvant Tamoxifen: Meta-Analysis of Heterogeneous Study Populations. https://app.cochat.ai/papers/10.1038/clpt.2013.186
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Province, M. A., Goetz, M. P., Brauch, H., Flockhart, D. A., Hebert, J. M., Whaley, R., Suman, V. J., Schroth, W., Winter, S., Zembutsu, H., Mushiroda, T., Newman, W. G., Lee, M.-T. M., Ambrosone, C. B., Beckmann, M. W., Choi, J.-Y., Dieudonné, A.-S., Fasching, P. A., Ferraldeschi, R., . . . Klein, T. E. (2014). CYP2D6 Genotype and Adjuvant Tamoxifen: Meta-Analysis of Heterogeneous Study Populations. Clinical Pharmacology & Therapeutics. https://doi.org/10.1038/clpt.2013.186

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