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Doctors must collaborate so that patients get full benefit of tamoxifen treatment
Date:3/24/2010

s. "Our study differs in that we have been able to take action as soon as we have discovered that a patient is taking interacting medication(s) by contacting the prescribing doctor in order to get them to switch to a different medication with no deleterious effect on tamoxifen metabolism."

In many cases, Mr. Hopkins was able to identify those patients using interacting SSRIs before starting tamoxifen treatment, either to give them time to be weaned off onto another class of drug or to start them on a different cancer therapy such as an aromatase inhibitor (AI). CYP2D6 inhibitors do not have the same effect on AIs, but one in five patients discontinue taking AIs because of side effects2; if they change to tamoxifen while continuing to take enzyme inhibitors, there may be a longer overlap of therapies, says Mr. Hopkins.

"For these patients, having the knowledge to be able to plan effectively in advance is important, as it can take many weeks to wean patients off CYP2D6 inhibitors, and this may affect their breast cancer therapy. The findings mean that good communication between all healthcare providers is more important than ever in order to eliminate the risk of reducing the efficacy of prescribed therapy," he will say.

Using drug data from his hospital's Breast Cancer Disease Site Group clinical database, the researchers logged any patient on tamoxifen or AI therapy as well as those on CYP2D6 inhibitors. A total of 531 patients were found to be eligible for the study; 463 received one of the prescribed hormonal therapies, while 68 were on a CYP2D6 inhibitor but not receiving hormonal treatment. Seven patients receiving tamoxifen and 16 taking an AI were also on a strong CYP2D6 inhibitor five percent of all the patients studied. One patient on tamoxifen and six on an AI were also receiving a moderate enzyme inhibitor, and 24 on tamoxifen and 40 on an AI were taking weak CYP2D6 inhibitors.

Tamoxifen must be metabolised in the li
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Contact: Mary Rice
mary@mrcommunication.org
ECCO-the European CanCer Organisation
Source:Eurekalert

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