Tamoxifen pharmacokinetics and pharmacodynamics in older patients with non-metastatic breast cancer
Background We aimed to study the pharmacokinetics and -dynamics of tamoxifen in older women with non-metastatic breast cancer. Methods Data for this analysis were derived from the CYPTAM study (NTR1509) database. Patients were stratified by age (age groups
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| Veröffentlicht in: | Breast cancer research and treatment 2023-06, Vol.199 (3), p.471-478 |
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| creator | Souwer, E. T. D. Sanchez-Spitman, A. Moes, D. J. A. R. Gelderblom, H. Swen, J. J. Portielje, J. E. A. Guchelaar, H. J. van Gelder, T. |
| description | Background
We aimed to study the pharmacokinetics and -dynamics of tamoxifen in older women with non-metastatic breast cancer.
Methods
Data for this analysis were derived from the CYPTAM study (NTR1509) database. Patients were stratified by age (age groups |
| doi_str_mv | 10.1007/s10549-023-06925-z |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10175413</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A748966508</galeid><sourcerecordid>A748966508</sourcerecordid><originalsourceid>FETCH-LOGICAL-c573t-74ebbee6ab5a326575a10bd8b3590fb0bdffad05e877b107e0c19e595d2e36533</originalsourceid><addsrcrecordid>eNp9kt-L1DAQx4Mo3rr6D_ggBUF86TlpmqR9kuPwFxz4cj6HNJ1uc7bJmqTq3V9v1j33bkUkhISZz3yTGb6EPKdwSgHkm0iB120JFStBtBUvbx6QFeWSlbKi8iFZARWyFA2IE_IkxisAaCW0j8kJkyCkoLAi5lLP_qcd0BXbUYdZG__VOkzWxEK7_hDsr52ed0HrCj_1GIqtThZdisUPm8bCeVfOmHRMOWyKLmC-FkY7g-EpeTToKeKz23NNvrx_d3n-sbz4_OHT-dlFafKfUylr7DpEoTuuWSW45JpC1zcd4y0MXb4Og-6BYyNlR0EiGNoib3lfIROcsTV5u9fdLt2Mvcm_C3pS22BnHa6V11YdZ5wd1cZ_VxSo5DXdKby-VQj-24IxqdlGg9OkHfolqqqBqq4YzWtNXv6FXvkluNxfpmiVNxPsjtroCZV1g88Pm52oOpN10wrBocnU6T-ovHrMM_cOB5vjRwWv7hWMqKc0Rj8tyXoXj8FqD5rgYww4HKZBQe1MpPYmUtlE6reJ1E0uenF_joeSP67JANsDMafcBsNd7_-R_QU9itNP</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2812281363</pqid></control><display><type>article</type><title>Tamoxifen pharmacokinetics and pharmacodynamics in older patients with non-metastatic breast cancer</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Souwer, E. T. D. ; Sanchez-Spitman, A. ; Moes, D. J. A. R. ; Gelderblom, H. ; Swen, J. J. ; Portielje, J. E. A. ; Guchelaar, H. J. ; van Gelder, T.</creator><creatorcontrib>Souwer, E. T. D. ; Sanchez-Spitman, A. ; Moes, D. J. A. R. ; Gelderblom, H. ; Swen, J. J. ; Portielje, J. E. A. ; Guchelaar, H. J. ; van Gelder, T.</creatorcontrib><description>Background
We aimed to study the pharmacokinetics and -dynamics of tamoxifen in older women with non-metastatic breast cancer.
Methods
Data for this analysis were derived from the CYPTAM study (NTR1509) database. Patients were stratified by age (age groups < 65 and 65 and older). Steady-state trough concentrations were measured of tamoxifen, N-desmethyltamoxifen, 4-hydroxy-tamoxifen, and endoxifen.
CYP2D6
and
CYP3A4
phenotypes were assessed for all patients by genotyping. Multiple linear regression models were used to analyze tamoxifen and endoxifen variability. Outcome data included recurrence-free survival at time of tamoxifen discontinuation (RFSt) and overall survival (OS).
Results
668 patients were included, 141 (21%) were 65 and older. Demographics and treatment duration were similar across age groups. Older patients had significantly higher concentrations of tamoxifen 129.4 ng/ml (SD 53.7) versus 112.2 ng/ml (SD 42.0) and endoxifen 12.1 ng/ml (SD 6.6) versus 10.7 ng/ml (SD 5.7,
p
all < 0.05), independently of
CYP2D6
and
CYP3A4
gene polymorphisms. Age independently explained 5% of the variability of tamoxifen (b = 0.95,
p
< 0.001,
R
2
= 0.051) and 0.1% of the variability in endoxifen concentrations (b = 0.45,
p
= 0.12,
R
2
= 0.007). Older patients had worse RFSt (5.8 versus 7.3 years,
p
= 0.01) and worse OS (7.8 years versus 8.7 years,
p
= 0.01). This was not related to differences in endoxifen concentration (HR 1.0, 95% CI 0.96–1.04,
p
= 0.84) or
CYP
polymorphisms.
Conclusion
Serum concentrations of tamoxifen and its demethylated metabolites are higher in older patients, independent of
CYP2D6
or
CYP3A4
gene polymorphisms. A higher bioavailability of tamoxifen in older patients may explain the observed differences. However, clinical relevance of these findings is limited and should not lead to a different tamoxifen dose in older patients.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-023-06925-z</identifier><identifier>PMID: 37067610</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Age groups ; Aged patients ; Analysis ; Antineoplastic Agents, Hormonal - pharmacology ; Antineoplastic Agents, Hormonal - therapeutic use ; Bioavailability ; Breast cancer ; Breast Neoplasms - drug therapy ; Breast Neoplasms - genetics ; Cancer research ; Clinical Trial ; CYP2D6 protein ; CYP3A4 gene ; Cytochrome P-450 CYP2D6 - genetics ; Cytochrome P-450 CYP3A - genetics ; Cytochrome P450 ; Female ; Gene polymorphism ; Genetic polymorphisms ; Genotype ; Genotyping ; Humans ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Metabolites ; Metastases ; Metastasis ; Oncology ; Patients ; Pharmacodynamics ; Pharmacokinetics ; Phenotypes ; Regression analysis ; Survival ; Tamoxifen ; Tamoxifen - pharmacology</subject><ispartof>Breast cancer research and treatment, 2023-06, Vol.199 (3), p.471-478</ispartof><rights>The Author(s) 2023</rights><rights>2023. The Author(s).</rights><rights>COPYRIGHT 2023 Springer</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c573t-74ebbee6ab5a326575a10bd8b3590fb0bdffad05e877b107e0c19e595d2e36533</citedby><cites>FETCH-LOGICAL-c573t-74ebbee6ab5a326575a10bd8b3590fb0bdffad05e877b107e0c19e595d2e36533</cites><orcidid>0000-0003-0489-7321</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-023-06925-z$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-023-06925-z$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37067610$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Souwer, E. T. D.</creatorcontrib><creatorcontrib>Sanchez-Spitman, A.</creatorcontrib><creatorcontrib>Moes, D. J. A. R.</creatorcontrib><creatorcontrib>Gelderblom, H.</creatorcontrib><creatorcontrib>Swen, J. J.</creatorcontrib><creatorcontrib>Portielje, J. E. A.</creatorcontrib><creatorcontrib>Guchelaar, H. J.</creatorcontrib><creatorcontrib>van Gelder, T.</creatorcontrib><title>Tamoxifen pharmacokinetics and pharmacodynamics in older patients with non-metastatic breast cancer</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>Background
We aimed to study the pharmacokinetics and -dynamics of tamoxifen in older women with non-metastatic breast cancer.
Methods
Data for this analysis were derived from the CYPTAM study (NTR1509) database. Patients were stratified by age (age groups < 65 and 65 and older). Steady-state trough concentrations were measured of tamoxifen, N-desmethyltamoxifen, 4-hydroxy-tamoxifen, and endoxifen.
CYP2D6
and
CYP3A4
phenotypes were assessed for all patients by genotyping. Multiple linear regression models were used to analyze tamoxifen and endoxifen variability. Outcome data included recurrence-free survival at time of tamoxifen discontinuation (RFSt) and overall survival (OS).
Results
668 patients were included, 141 (21%) were 65 and older. Demographics and treatment duration were similar across age groups. Older patients had significantly higher concentrations of tamoxifen 129.4 ng/ml (SD 53.7) versus 112.2 ng/ml (SD 42.0) and endoxifen 12.1 ng/ml (SD 6.6) versus 10.7 ng/ml (SD 5.7,
p
all < 0.05), independently of
CYP2D6
and
CYP3A4
gene polymorphisms. Age independently explained 5% of the variability of tamoxifen (b = 0.95,
p
< 0.001,
R
2
= 0.051) and 0.1% of the variability in endoxifen concentrations (b = 0.45,
p
= 0.12,
R
2
= 0.007). Older patients had worse RFSt (5.8 versus 7.3 years,
p
= 0.01) and worse OS (7.8 years versus 8.7 years,
p
= 0.01). This was not related to differences in endoxifen concentration (HR 1.0, 95% CI 0.96–1.04,
p
= 0.84) or
CYP
polymorphisms.
Conclusion
Serum concentrations of tamoxifen and its demethylated metabolites are higher in older patients, independent of
CYP2D6
or
CYP3A4
gene polymorphisms. A higher bioavailability of tamoxifen in older patients may explain the observed differences. However, clinical relevance of these findings is limited and should not lead to a different tamoxifen dose in older patients.</description><subject>Age groups</subject><subject>Aged patients</subject><subject>Analysis</subject><subject>Antineoplastic Agents, Hormonal - pharmacology</subject><subject>Antineoplastic Agents, Hormonal - therapeutic use</subject><subject>Bioavailability</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - genetics</subject><subject>Cancer research</subject><subject>Clinical Trial</subject><subject>CYP2D6 protein</subject><subject>CYP3A4 gene</subject><subject>Cytochrome P-450 CYP2D6 - genetics</subject><subject>Cytochrome P-450 CYP3A - genetics</subject><subject>Cytochrome P450</subject><subject>Female</subject><subject>Gene polymorphism</subject><subject>Genetic polymorphisms</subject><subject>Genotype</subject><subject>Genotyping</subject><subject>Humans</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Metabolites</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Oncology</subject><subject>Patients</subject><subject>Pharmacodynamics</subject><subject>Pharmacokinetics</subject><subject>Phenotypes</subject><subject>Regression analysis</subject><subject>Survival</subject><subject>Tamoxifen</subject><subject>Tamoxifen - pharmacology</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kt-L1DAQx4Mo3rr6D_ggBUF86TlpmqR9kuPwFxz4cj6HNJ1uc7bJmqTq3V9v1j33bkUkhISZz3yTGb6EPKdwSgHkm0iB120JFStBtBUvbx6QFeWSlbKi8iFZARWyFA2IE_IkxisAaCW0j8kJkyCkoLAi5lLP_qcd0BXbUYdZG__VOkzWxEK7_hDsr52ed0HrCj_1GIqtThZdisUPm8bCeVfOmHRMOWyKLmC-FkY7g-EpeTToKeKz23NNvrx_d3n-sbz4_OHT-dlFafKfUylr7DpEoTuuWSW45JpC1zcd4y0MXb4Og-6BYyNlR0EiGNoib3lfIROcsTV5u9fdLt2Mvcm_C3pS22BnHa6V11YdZ5wd1cZ_VxSo5DXdKby-VQj-24IxqdlGg9OkHfolqqqBqq4YzWtNXv6FXvkluNxfpmiVNxPsjtroCZV1g88Pm52oOpN10wrBocnU6T-ovHrMM_cOB5vjRwWv7hWMqKc0Rj8tyXoXj8FqD5rgYww4HKZBQe1MpPYmUtlE6reJ1E0uenF_joeSP67JANsDMafcBsNd7_-R_QU9itNP</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Souwer, E. T. D.</creator><creator>Sanchez-Spitman, A.</creator><creator>Moes, D. J. A. R.</creator><creator>Gelderblom, H.</creator><creator>Swen, J. J.</creator><creator>Portielje, J. E. A.</creator><creator>Guchelaar, H. J.</creator><creator>van Gelder, T.</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</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>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0489-7321</orcidid></search><sort><creationdate>20230601</creationdate><title>Tamoxifen pharmacokinetics and pharmacodynamics in older patients with non-metastatic breast cancer</title><author>Souwer, E. T. D. ; Sanchez-Spitman, A. ; Moes, D. J. A. R. ; Gelderblom, H. ; Swen, J. J. ; Portielje, J. E. A. ; Guchelaar, H. J. ; van Gelder, T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c573t-74ebbee6ab5a326575a10bd8b3590fb0bdffad05e877b107e0c19e595d2e36533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Age groups</topic><topic>Aged patients</topic><topic>Analysis</topic><topic>Antineoplastic Agents, Hormonal - pharmacology</topic><topic>Antineoplastic Agents, Hormonal - therapeutic use</topic><topic>Bioavailability</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - genetics</topic><topic>Cancer research</topic><topic>Clinical Trial</topic><topic>CYP2D6 protein</topic><topic>CYP3A4 gene</topic><topic>Cytochrome P-450 CYP2D6 - genetics</topic><topic>Cytochrome P-450 CYP3A - genetics</topic><topic>Cytochrome P450</topic><topic>Female</topic><topic>Gene polymorphism</topic><topic>Genetic polymorphisms</topic><topic>Genotype</topic><topic>Genotyping</topic><topic>Humans</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Metabolites</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Oncology</topic><topic>Patients</topic><topic>Pharmacodynamics</topic><topic>Pharmacokinetics</topic><topic>Phenotypes</topic><topic>Regression analysis</topic><topic>Survival</topic><topic>Tamoxifen</topic><topic>Tamoxifen - pharmacology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Souwer, E. T. D.</creatorcontrib><creatorcontrib>Sanchez-Spitman, A.</creatorcontrib><creatorcontrib>Moes, D. J. A. R.</creatorcontrib><creatorcontrib>Gelderblom, H.</creatorcontrib><creatorcontrib>Swen, J. J.</creatorcontrib><creatorcontrib>Portielje, J. E. A.</creatorcontrib><creatorcontrib>Guchelaar, H. J.</creatorcontrib><creatorcontrib>van Gelder, T.</creatorcontrib><collection>Springer Nature OA Free Journals</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>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</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>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Souwer, E. T. D.</au><au>Sanchez-Spitman, A.</au><au>Moes, D. J. A. R.</au><au>Gelderblom, H.</au><au>Swen, J. J.</au><au>Portielje, J. E. A.</au><au>Guchelaar, H. J.</au><au>van Gelder, T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tamoxifen pharmacokinetics and pharmacodynamics in older patients with non-metastatic breast cancer</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>199</volume><issue>3</issue><spage>471</spage><epage>478</epage><pages>471-478</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><abstract>Background
We aimed to study the pharmacokinetics and -dynamics of tamoxifen in older women with non-metastatic breast cancer.
Methods
Data for this analysis were derived from the CYPTAM study (NTR1509) database. Patients were stratified by age (age groups < 65 and 65 and older). Steady-state trough concentrations were measured of tamoxifen, N-desmethyltamoxifen, 4-hydroxy-tamoxifen, and endoxifen.
CYP2D6
and
CYP3A4
phenotypes were assessed for all patients by genotyping. Multiple linear regression models were used to analyze tamoxifen and endoxifen variability. Outcome data included recurrence-free survival at time of tamoxifen discontinuation (RFSt) and overall survival (OS).
Results
668 patients were included, 141 (21%) were 65 and older. Demographics and treatment duration were similar across age groups. Older patients had significantly higher concentrations of tamoxifen 129.4 ng/ml (SD 53.7) versus 112.2 ng/ml (SD 42.0) and endoxifen 12.1 ng/ml (SD 6.6) versus 10.7 ng/ml (SD 5.7,
p
all < 0.05), independently of
CYP2D6
and
CYP3A4
gene polymorphisms. Age independently explained 5% of the variability of tamoxifen (b = 0.95,
p
< 0.001,
R
2
= 0.051) and 0.1% of the variability in endoxifen concentrations (b = 0.45,
p
= 0.12,
R
2
= 0.007). Older patients had worse RFSt (5.8 versus 7.3 years,
p
= 0.01) and worse OS (7.8 years versus 8.7 years,
p
= 0.01). This was not related to differences in endoxifen concentration (HR 1.0, 95% CI 0.96–1.04,
p
= 0.84) or
CYP
polymorphisms.
Conclusion
Serum concentrations of tamoxifen and its demethylated metabolites are higher in older patients, independent of
CYP2D6
or
CYP3A4
gene polymorphisms. A higher bioavailability of tamoxifen in older patients may explain the observed differences. However, clinical relevance of these findings is limited and should not lead to a different tamoxifen dose in older patients.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>37067610</pmid><doi>10.1007/s10549-023-06925-z</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0489-7321</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-6806 |
| ispartof | Breast cancer research and treatment, 2023-06, Vol.199 (3), p.471-478 |
| issn | 0167-6806 1573-7217 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Age groups Aged patients Analysis Antineoplastic Agents, Hormonal - pharmacology Antineoplastic Agents, Hormonal - therapeutic use Bioavailability Breast cancer Breast Neoplasms - drug therapy Breast Neoplasms - genetics Cancer research Clinical Trial CYP2D6 protein CYP3A4 gene Cytochrome P-450 CYP2D6 - genetics Cytochrome P-450 CYP3A - genetics Cytochrome P450 Female Gene polymorphism Genetic polymorphisms Genotype Genotyping Humans Medical research Medicine Medicine & Public Health Medicine, Experimental Metabolites Metastases Metastasis Oncology Patients Pharmacodynamics Pharmacokinetics Phenotypes Regression analysis Survival Tamoxifen Tamoxifen - pharmacology |
| title | Tamoxifen pharmacokinetics and pharmacodynamics in older patients with non-metastatic breast cancer |
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