Wildlife cancer and plastic pollution

McAloose, Denise; Newton, Alisa L.

doi:10.1038/nrc2665-c2

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…Genotype-based prediction of CYP2D6 enzymatic activity ( [2] [3] [4]; see also Links section) categorizes patients into: Ultra metabolizers (carrying multiple or duplicated functional alleles) Extensive metabolizers (carrying “normal” function alleles) Intermediate metabolizers Slow metabolizers (carrying only no-or low-function alleles) …”

Section: Test Descriptionmentioning

confidence: 99%

CYP2D6 testing to predict response to tamoxifen in women with breast cancerPharmacogenomic

et al. 2010

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Tamoxifen, a selective estrogen receptor modulator, is the standard of care for premenopausal women with estrogen or progesterone receptor-positive breast cancer and a valid option for treating post-menopausal women. However, a substantial number of tamoxifen-treated patients relapse following surgical resection, while others remain disease-free for many years. It appears that the primary effectors of tamoxifen activity are its active metabolites, rather than tamoxifen itself. Cytochrome P450 (CYP) enzymes, CYP2D6 in particular, play a major role in the metabolism of tamoxifen to active metabolites. More than 75 germline CYP2D6 variants have been identified.A test predicting lack of response to tamoxifen could supplement information used by clinicians and patients in treatment decision-making. For example, physicians and patients may opt to switch to an alternative therapy upfront. Clinical ScenarioTesting of women with non-metastatic breast cancer to predict those who will not respond to tamoxifen therapy could inform decisions regarding choice of alternative treatment strategies including chemotherapy or the use of aromatase inhibitors (for post-menopausal women in particular [1] . Test DescriptionAnalysis of multiple single nucleotide polymorphisms, deletions or duplications inCYP2D6by DNA-based methods. Public Health ImportanceIt is estimated that approximately 192,000 U.S. women will be diagnosed with breast cancer and that 40,170 women will die of the disease [5] . More than 80 percent of all breast cancers express estrogen or progesterone receptors, and are candidates for endocrine therapy, including tamoxifen treatment.An individual-patient data meta-analysis of 194 randomized controlled trials (145,000 patients) has demonstrated that tamoxifen reduces the risk of breast cancer relapse by about 50 percent and the risk of breast-cancer specific mortality by about 30 percent [1] .There are effective treatment strategies that do not include tamoxifen. Published Reviews, Recommendations and Guidelines AbstractTamoxifen, a selective estrogen receptor modulator, is the standard of care for premenopausal women with estrogen or progesterone receptor-positive breast cancer and a valid option for treating post-menopausal women. However, a substantial number of tamoxifen-treated patients relapse following surgical resection, while others remain disease-free for many years. It appears that the primary effectors of tamoxifen activity are its active metabolites, rather than tamoxifen itself. Cytochrome P450 (CYP) enzymes, CYP2D6 in particular, play a major role in the metabolism of tamoxifen to active metabolites. More than 75 germline CYP2D6 variants have been identified.A test predicting lack of response to tamoxifen could supplement information used by clinicians and patients in treatment decision-making. For example, physicians and patients may opt to switch to an alternative therapy upfront.

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