Evidence map›Paper›PMID 40910489›Full record

ArticleJournal of clinical pharmacology2025

From Genotype to Therapeutic Monitoring: Enhancing Tamoxifen Efficacy in Breast Cancer Treatment.

Ana Flávia Mendes Batista, Letícia Penteado Petrolli, Maria Paula Marques Pereira, Adriana Rocha, Jurandyr Moreira de Andrade, Vera Lucia Lanchote, João Paulo Bianchi Ximenez

Abstract read
In one paragraph

Article in Journal of clinical pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ana Flávia Mendes BatistaSchool of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
Letícia Penteado PetrolliSchool of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil.ORCID 0009-0008-6412-2599
Maria Paula Marques PereiraSchool of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
Adriana RochaSchool of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
Jurandyr Moreira de AndradeRibeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
Vera Lucia LanchoteSchool of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil.ORCID 0000-0002-0074-4953
João Paulo Bianchi XimenezSchool of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil.ORCID 0000-0002-6414-5220

Funding

Conselho Nacional de Desenvolvimento Científico e TecnológicoCoordenação de Aperfeiçoamento de Pessoal em Nível SuperiorFundação de Amparo à Pesquisa do Estado de São Paulo 2014/16360-9
6 · The paper itself

Abstract

Endoxifen is the most active metabolite of tamoxifen and plays a central role in its therapeutic efficacy. However, significant interindividual variability in endoxifen plasma concentrations, driven by both genetic and non-genetic factors, may result in subtherapeutic exposure for a substantial subset of patients. This study evaluated the influence of CYP2D6 phenotype and age on endoxifen steady-state concentrations and explored the clinical utility of therapeutic drug monitoring (TDM) to guide tamoxifen therapy. A total of 63 breast cancer patients receiving tamoxifen 20 mg daily for at least 3 months were enrolled. Patients were genotyped for CYP2D6 using TaqMan assays and classified as normal metabolizers (NMs, n = 49), intermediate metabolizers (IMs, n = 13), or ultrarapid metabolizers (UMs, n = 1). Plasma concentrations of tamoxifen and its metabolites were quantified by LC-MS/MS at steady state. Endoxifen levels were significantly lower in IMs (7.13  ng/mL; 95% CI: 3.38-15.08) compared to NMs (22.66  ng/mL; 95% CI: 18.57-27.66; P  <  .001). Subtherapeutic endoxifen concentrations (<6  ng/mL) were observed in 23.1% of IMs and 4.1% of NMs. These results support the combined use of CYP2D6 genotyping and TDM as the optimal strategy for personalizing tamoxifen therapy and minimizing the risk of subtherapeutic endoxifen exposure.

Indexed as

Antineoplastic Agents, HormonalBreast NeoplasmsCytochrome P-450 CYP2D6Drug MonitoringTamoxifenAdultAgedFemaleGenotypeHumansMiddle AgedPhenotype4-hydroxy-N-desmethyltamoxifenAntineoplastic Agents, HormonalCytochrome P-450 CYP2D6TamoxifenCYP2D6endoxifenpharmacogeneticspharmacokineticstamoxifentherapeutic drug monitoring

Identifiers

PMID40910489
PMCPMC12649294

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.