Genetic polymorphisms of CYP2D6 increase the risk for recurrence of breast cancer in patients receiving tamoxifen as an adjuvant therapy
Purpose Tamoxifen is used in the treatment of breast cancer to prevent recurrences. It is converted to its active metabolite endoxifen by CYP2D6 enzyme. This study was conducted to evaluate the influence of CYP2D6 genetic polymorphisms on the recurrence of breast cancer in patients receiving treatme...
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| Veröffentlicht in: | Cancer chemotherapy and pharmacology 2012-07, Vol.70 (1), p.75-81 |
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| creator | Damodaran, Solai Elango Pradhan, Suresh Chandra Umamaheswaran, Gurusamy Kadambari, Dharanipragada Reddy, K. Sathyanarayana Adithan, Chandrasekaran |
| description | Purpose
Tamoxifen is used in the treatment of breast cancer to prevent recurrences. It is converted to its active metabolite endoxifen by CYP2D6 enzyme. This study was conducted to evaluate the influence of
CYP2D6
genetic polymorphisms on the recurrence of breast cancer in patients receiving treatment with tamoxifen as an adjuvant hormonal therapy.
Methods
Breast cancer patients (
n
= 141) on adjuvant tamoxifen and not on any concomitant CYP2D6 inhibitors were recruited for the study. Patient characteristics and treatment history were obtained. Five milliliters of venous blood was collected for genotyping
CYP2D6
alleles
*1
,
*2
,
*4
,
*5
and
*10
. CYP2D6 activity score was calculated to determine the phenotype based on genotype. The activity scores were compared between patients with recurrence and patients with no recurrence of breast cancer.
Results
Of the 141 patients recruited for the study, genotyping was done for 132 of them. CYP2D6 activity score ≤0.5 is associated with a statistically significant increased risk of recurrence (OR—12.37; 95 % CI—3.23, 47.33;
p
|
| doi_str_mv | 10.1007/s00280-012-1891-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1753506204</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1753506204</sourcerecordid><originalsourceid>FETCH-LOGICAL-c501t-9bd5b018d77ba5dcd0dcd0d7a1ed327f798918dff13855d7adced3dd36d3e1423</originalsourceid><addsrcrecordid>eNqFkc1u1DAUhS1ERYeBB2CDLCEkNinXf3FmiaZQkCrBAhasIse-aT0kTrCTinkDHrtOZ6AICbGwrev7neOfQ8gzBmcMQL9OALyCAhgvWLVhBXtAVkwKXkAlxUOyAiFloTTIU_I4pR0ASCbEI3LKeckFZ3xFfl5gwMlbOg7dvh_ieO1Tn-jQ0u3XT_y8pD7YiCYhna6RRp--0XaINKKdY8RgcUGbhZioNbmOWUFHM3kMU1o49Dc-XNHJ9MMP32KgJlGTZ7ebb0yYFt9oxv0TctKaLuHT47omX969_bx9X1x-vPiwfXNZWAVsKjaNUw2wymndGOWsg7uhDUMnuG71Jn9E5dqWiUqpvO9sbjgnSieQSS7W5NXBd4zD9xnTVPc-Wew6E3CYU820EgpKDvL_KHCu1EbpxfXFX-humGPID7mjuNRV9l0TdqBsHFKK2NZj9L2J-wzVS6L1IdE6J1ovidYsa54fneemR_db8SvCDLw8AiZZ07Uxp-DTPVcKJTUsRvzApdwKVxj_vOK_Tr8F5-W5bQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1022247875</pqid></control><display><type>article</type><title>Genetic polymorphisms of CYP2D6 increase the risk for recurrence of breast cancer in patients receiving tamoxifen as an adjuvant therapy</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Damodaran, Solai Elango ; Pradhan, Suresh Chandra ; Umamaheswaran, Gurusamy ; Kadambari, Dharanipragada ; Reddy, K. Sathyanarayana ; Adithan, Chandrasekaran</creator><creatorcontrib>Damodaran, Solai Elango ; Pradhan, Suresh Chandra ; Umamaheswaran, Gurusamy ; Kadambari, Dharanipragada ; Reddy, K. Sathyanarayana ; Adithan, Chandrasekaran</creatorcontrib><description>Purpose
Tamoxifen is used in the treatment of breast cancer to prevent recurrences. It is converted to its active metabolite endoxifen by CYP2D6 enzyme. This study was conducted to evaluate the influence of
CYP2D6
genetic polymorphisms on the recurrence of breast cancer in patients receiving treatment with tamoxifen as an adjuvant hormonal therapy.
Methods
Breast cancer patients (
n
= 141) on adjuvant tamoxifen and not on any concomitant CYP2D6 inhibitors were recruited for the study. Patient characteristics and treatment history were obtained. Five milliliters of venous blood was collected for genotyping
CYP2D6
alleles
*1
,
*2
,
*4
,
*5
and
*10
. CYP2D6 activity score was calculated to determine the phenotype based on genotype. The activity scores were compared between patients with recurrence and patients with no recurrence of breast cancer.
Results
Of the 141 patients recruited for the study, genotyping was done for 132 of them. CYP2D6 activity score ≤0.5 is associated with a statistically significant increased risk of recurrence (OR—12.37; 95 % CI—3.23, 47.33;
p
< 0.001) and shorter recurrence free survival (52.68 ± 10.58 months (mean ± SEM);
p
< 0.001) as was shown in Kaplan–Meir survival estimates, when compared to activity score ≥1. The hazard ratio for activity score ≤0.5 is 7.29 (
p
< 0.001) when compared to activity score ≥1. Analysis of known estrogen receptor positive patients also showed statistically significant increased risk of recurrence and shorter recurrence free survival in patients with CYP2D6 activity score ≤0.5. The Cox proportional hazard ratio was found to be 7.15 (
p
= 0.006) for activity score ≤0.5.
Conclusion
Reduced CYP2D6 activity is associated with poor treatment outcomes, in terms of increased risk of recurrence and shorter recurrence free survival, in breast cancer patients on adjuvant tamoxifen therapy.</description><identifier>ISSN: 0344-5704</identifier><identifier>EISSN: 1432-0843</identifier><identifier>DOI: 10.1007/s00280-012-1891-1</identifier><identifier>PMID: 22623212</identifier><identifier>CODEN: CCPHDZ</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adult ; Aged ; Alleles ; Antineoplastic agents ; Antineoplastic Agents, Hormonal - therapeutic use ; Biological and medical sciences ; Breast Neoplasms - drug therapy ; Breast Neoplasms - genetics ; Breast Neoplasms - metabolism ; Cancer Research ; Chemotherapy, Adjuvant ; Cytochrome P-450 CYP2D6 - genetics ; Cytochrome P-450 CYP2D6 - metabolism ; Female ; Gene Frequency ; Genotype ; Gynecology. Andrology. Obstetrics ; Humans ; Isoenzymes - genetics ; Kaplan-Meier Estimate ; Mammary gland diseases ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Recurrence, Local ; Oncology ; Original Article ; Pharmacology. Drug treatments ; Pharmacology/Toxicology ; Polymorphism, Genetic ; Proportional Hazards Models ; Receptors, Estrogen - metabolism ; Risk Assessment - statistics & numerical data ; Risk Factors ; Tamoxifen - therapeutic use ; Tumors</subject><ispartof>Cancer chemotherapy and pharmacology, 2012-07, Vol.70 (1), p.75-81</ispartof><rights>Springer-Verlag 2012</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c501t-9bd5b018d77ba5dcd0dcd0d7a1ed327f798918dff13855d7adced3dd36d3e1423</citedby><cites>FETCH-LOGICAL-c501t-9bd5b018d77ba5dcd0dcd0d7a1ed327f798918dff13855d7adced3dd36d3e1423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00280-012-1891-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00280-012-1891-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26354701$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22623212$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Damodaran, Solai Elango</creatorcontrib><creatorcontrib>Pradhan, Suresh Chandra</creatorcontrib><creatorcontrib>Umamaheswaran, Gurusamy</creatorcontrib><creatorcontrib>Kadambari, Dharanipragada</creatorcontrib><creatorcontrib>Reddy, K. Sathyanarayana</creatorcontrib><creatorcontrib>Adithan, Chandrasekaran</creatorcontrib><title>Genetic polymorphisms of CYP2D6 increase the risk for recurrence of breast cancer in patients receiving tamoxifen as an adjuvant therapy</title><title>Cancer chemotherapy and pharmacology</title><addtitle>Cancer Chemother Pharmacol</addtitle><addtitle>Cancer Chemother Pharmacol</addtitle><description>Purpose
Tamoxifen is used in the treatment of breast cancer to prevent recurrences. It is converted to its active metabolite endoxifen by CYP2D6 enzyme. This study was conducted to evaluate the influence of
CYP2D6
genetic polymorphisms on the recurrence of breast cancer in patients receiving treatment with tamoxifen as an adjuvant hormonal therapy.
Methods
Breast cancer patients (
n
= 141) on adjuvant tamoxifen and not on any concomitant CYP2D6 inhibitors were recruited for the study. Patient characteristics and treatment history were obtained. Five milliliters of venous blood was collected for genotyping
CYP2D6
alleles
*1
,
*2
,
*4
,
*5
and
*10
. CYP2D6 activity score was calculated to determine the phenotype based on genotype. The activity scores were compared between patients with recurrence and patients with no recurrence of breast cancer.
Results
Of the 141 patients recruited for the study, genotyping was done for 132 of them. CYP2D6 activity score ≤0.5 is associated with a statistically significant increased risk of recurrence (OR—12.37; 95 % CI—3.23, 47.33;
p
< 0.001) and shorter recurrence free survival (52.68 ± 10.58 months (mean ± SEM);
p
< 0.001) as was shown in Kaplan–Meir survival estimates, when compared to activity score ≥1. The hazard ratio for activity score ≤0.5 is 7.29 (
p
< 0.001) when compared to activity score ≥1. Analysis of known estrogen receptor positive patients also showed statistically significant increased risk of recurrence and shorter recurrence free survival in patients with CYP2D6 activity score ≤0.5. The Cox proportional hazard ratio was found to be 7.15 (
p
= 0.006) for activity score ≤0.5.
Conclusion
Reduced CYP2D6 activity is associated with poor treatment outcomes, in terms of increased risk of recurrence and shorter recurrence free survival, in breast cancer patients on adjuvant tamoxifen therapy.</description><subject>Adult</subject><subject>Aged</subject><subject>Alleles</subject><subject>Antineoplastic agents</subject><subject>Antineoplastic Agents, Hormonal - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - genetics</subject><subject>Breast Neoplasms - metabolism</subject><subject>Cancer Research</subject><subject>Chemotherapy, Adjuvant</subject><subject>Cytochrome P-450 CYP2D6 - genetics</subject><subject>Cytochrome P-450 CYP2D6 - metabolism</subject><subject>Female</subject><subject>Gene Frequency</subject><subject>Genotype</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Isoenzymes - genetics</subject><subject>Kaplan-Meier Estimate</subject><subject>Mammary gland diseases</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Pharmacology. Drug treatments</subject><subject>Pharmacology/Toxicology</subject><subject>Polymorphism, Genetic</subject><subject>Proportional Hazards Models</subject><subject>Receptors, Estrogen - metabolism</subject><subject>Risk Assessment - statistics & numerical data</subject><subject>Risk Factors</subject><subject>Tamoxifen - therapeutic use</subject><subject>Tumors</subject><issn>0344-5704</issn><issn>1432-0843</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkc1u1DAUhS1ERYeBB2CDLCEkNinXf3FmiaZQkCrBAhasIse-aT0kTrCTinkDHrtOZ6AICbGwrev7neOfQ8gzBmcMQL9OALyCAhgvWLVhBXtAVkwKXkAlxUOyAiFloTTIU_I4pR0ASCbEI3LKeckFZ3xFfl5gwMlbOg7dvh_ieO1Tn-jQ0u3XT_y8pD7YiCYhna6RRp--0XaINKKdY8RgcUGbhZioNbmOWUFHM3kMU1o49Dc-XNHJ9MMP32KgJlGTZ7ebb0yYFt9oxv0TctKaLuHT47omX969_bx9X1x-vPiwfXNZWAVsKjaNUw2wymndGOWsg7uhDUMnuG71Jn9E5dqWiUqpvO9sbjgnSieQSS7W5NXBd4zD9xnTVPc-Wew6E3CYU820EgpKDvL_KHCu1EbpxfXFX-humGPID7mjuNRV9l0TdqBsHFKK2NZj9L2J-wzVS6L1IdE6J1ovidYsa54fneemR_db8SvCDLw8AiZZ07Uxp-DTPVcKJTUsRvzApdwKVxj_vOK_Tr8F5-W5bQ</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Damodaran, Solai Elango</creator><creator>Pradhan, Suresh Chandra</creator><creator>Umamaheswaran, Gurusamy</creator><creator>Kadambari, Dharanipragada</creator><creator>Reddy, K. Sathyanarayana</creator><creator>Adithan, Chandrasekaran</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>RC3</scope></search><sort><creationdate>20120701</creationdate><title>Genetic polymorphisms of CYP2D6 increase the risk for recurrence of breast cancer in patients receiving tamoxifen as an adjuvant therapy</title><author>Damodaran, Solai Elango ; Pradhan, Suresh Chandra ; Umamaheswaran, Gurusamy ; Kadambari, Dharanipragada ; Reddy, K. Sathyanarayana ; Adithan, Chandrasekaran</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c501t-9bd5b018d77ba5dcd0dcd0d7a1ed327f798918dff13855d7adced3dd36d3e1423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Alleles</topic><topic>Antineoplastic agents</topic><topic>Antineoplastic Agents, Hormonal - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - genetics</topic><topic>Breast Neoplasms - metabolism</topic><topic>Cancer Research</topic><topic>Chemotherapy, Adjuvant</topic><topic>Cytochrome P-450 CYP2D6 - genetics</topic><topic>Cytochrome P-450 CYP2D6 - metabolism</topic><topic>Female</topic><topic>Gene Frequency</topic><topic>Genotype</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Isoenzymes - genetics</topic><topic>Kaplan-Meier Estimate</topic><topic>Mammary gland diseases</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Pharmacology. Drug treatments</topic><topic>Pharmacology/Toxicology</topic><topic>Polymorphism, Genetic</topic><topic>Proportional Hazards Models</topic><topic>Receptors, Estrogen - metabolism</topic><topic>Risk Assessment - statistics & numerical data</topic><topic>Risk Factors</topic><topic>Tamoxifen - therapeutic use</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Damodaran, Solai Elango</creatorcontrib><creatorcontrib>Pradhan, Suresh Chandra</creatorcontrib><creatorcontrib>Umamaheswaran, Gurusamy</creatorcontrib><creatorcontrib>Kadambari, Dharanipragada</creatorcontrib><creatorcontrib>Reddy, K. Sathyanarayana</creatorcontrib><creatorcontrib>Adithan, Chandrasekaran</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><jtitle>Cancer chemotherapy and pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Damodaran, Solai Elango</au><au>Pradhan, Suresh Chandra</au><au>Umamaheswaran, Gurusamy</au><au>Kadambari, Dharanipragada</au><au>Reddy, K. Sathyanarayana</au><au>Adithan, Chandrasekaran</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Genetic polymorphisms of CYP2D6 increase the risk for recurrence of breast cancer in patients receiving tamoxifen as an adjuvant therapy</atitle><jtitle>Cancer chemotherapy and pharmacology</jtitle><stitle>Cancer Chemother Pharmacol</stitle><addtitle>Cancer Chemother Pharmacol</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>70</volume><issue>1</issue><spage>75</spage><epage>81</epage><pages>75-81</pages><issn>0344-5704</issn><eissn>1432-0843</eissn><coden>CCPHDZ</coden><abstract>Purpose
Tamoxifen is used in the treatment of breast cancer to prevent recurrences. It is converted to its active metabolite endoxifen by CYP2D6 enzyme. This study was conducted to evaluate the influence of
CYP2D6
genetic polymorphisms on the recurrence of breast cancer in patients receiving treatment with tamoxifen as an adjuvant hormonal therapy.
Methods
Breast cancer patients (
n
= 141) on adjuvant tamoxifen and not on any concomitant CYP2D6 inhibitors were recruited for the study. Patient characteristics and treatment history were obtained. Five milliliters of venous blood was collected for genotyping
CYP2D6
alleles
*1
,
*2
,
*4
,
*5
and
*10
. CYP2D6 activity score was calculated to determine the phenotype based on genotype. The activity scores were compared between patients with recurrence and patients with no recurrence of breast cancer.
Results
Of the 141 patients recruited for the study, genotyping was done for 132 of them. CYP2D6 activity score ≤0.5 is associated with a statistically significant increased risk of recurrence (OR—12.37; 95 % CI—3.23, 47.33;
p
< 0.001) and shorter recurrence free survival (52.68 ± 10.58 months (mean ± SEM);
p
< 0.001) as was shown in Kaplan–Meir survival estimates, when compared to activity score ≥1. The hazard ratio for activity score ≤0.5 is 7.29 (
p
< 0.001) when compared to activity score ≥1. Analysis of known estrogen receptor positive patients also showed statistically significant increased risk of recurrence and shorter recurrence free survival in patients with CYP2D6 activity score ≤0.5. The Cox proportional hazard ratio was found to be 7.15 (
p
= 0.006) for activity score ≤0.5.
Conclusion
Reduced CYP2D6 activity is associated with poor treatment outcomes, in terms of increased risk of recurrence and shorter recurrence free survival, in breast cancer patients on adjuvant tamoxifen therapy.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22623212</pmid><doi>10.1007/s00280-012-1891-1</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0344-5704 |
| ispartof | Cancer chemotherapy and pharmacology, 2012-07, Vol.70 (1), p.75-81 |
| issn | 0344-5704 1432-0843 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1753506204 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Aged Alleles Antineoplastic agents Antineoplastic Agents, Hormonal - therapeutic use Biological and medical sciences Breast Neoplasms - drug therapy Breast Neoplasms - genetics Breast Neoplasms - metabolism Cancer Research Chemotherapy, Adjuvant Cytochrome P-450 CYP2D6 - genetics Cytochrome P-450 CYP2D6 - metabolism Female Gene Frequency Genotype Gynecology. Andrology. Obstetrics Humans Isoenzymes - genetics Kaplan-Meier Estimate Mammary gland diseases Medical sciences Medicine Medicine & Public Health Middle Aged Neoplasm Recurrence, Local Oncology Original Article Pharmacology. Drug treatments Pharmacology/Toxicology Polymorphism, Genetic Proportional Hazards Models Receptors, Estrogen - metabolism Risk Assessment - statistics & numerical data Risk Factors Tamoxifen - therapeutic use Tumors |
| title | Genetic polymorphisms of CYP2D6 increase the risk for recurrence of breast cancer in patients receiving tamoxifen as an adjuvant therapy |
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