Effects of CYP2D6*10 polymorphism on tamoxifen pharmacokinetics in patients with breast cancer in Asia: a meta-analysis

Cancer Chemother Pharmacol. 2019 Jan;83(1):71-79. doi: 10.1007/s00280-018-3703-8. Epub 2018 Oct 24.

Abstract

Purpose: Insufficient serum metabolite concentrations of tamoxifen can compromise treatment efficacy in patients with breast cancer. The purpose of this meta-analysis was to explore correlations between cytochrome P450 (CYP) 2D6*10 gene polymorphisms and serum concentrations of tamoxifen and its active metabolites in patients with breast cancer in Asia.

Methods: The study included a systematic literature search for cohort studies published before March 2018 in English databases (PubMed, Embase, Cochrane Library, and Web of Science) and Chinese databases (Chinese National Knowledge Infrastructure and Wan Fang database). The meta-analysis was performed using RevMan 5.3 software. Pooled means and standard deviations were calculated with 95% confidence intervals. Publication bias and sensitivity analyses were also performed using STATA 14.0.

Results: In total, 7 studies and 552 patients were included in the meta-analysis. Serum concentrations of endoxifen were significantly different in each CYP2D6*10 genotype group (p < 0.05). The CC genotype was associated with higher concentrations of 4-OH-TAM than the CT/TT genotype (p < 0.05). However, there were no statistically significant between-group differences in serum concentrations of TAM (p > 0.05). Publication bias and sensitivity analyses confirmed that the meta-analysis results were stable and reliable.

Conclusions: CYP2D6*10 polymorphisms influence the pharmacokinetics of tamoxifen in patients with breast cancer in Asia.

Keywords: Breast cancer; CYP2D6*10; Pharmacokinetics; Polymorphism; Tamoxifen.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents, Hormonal / pharmacokinetics
  • Antineoplastic Agents, Hormonal / pharmacology
  • Asia / epidemiology
  • Asian People / genetics*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / metabolism*
  • Cytochrome P-450 CYP2D6 / genetics*
  • Female
  • Humans
  • Polymorphism, Genetic*
  • Tamoxifen / pharmacokinetics*
  • Tamoxifen / pharmacology
  • Tissue Distribution
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Hormonal
  • Tamoxifen
  • Cytochrome P-450 CYP2D6