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Interpreting the CYP2D6 Results From the International Tamoxifen Pharmacogenetics Consortium
Author(s) -
Province M A,
Altman R B,
Klein T E
Publication year - 2014
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.2014.100
Subject(s) - tamoxifen , cyp2d6 , pharmacogenetics , breast cancer , medicine , oncology , post hoc analysis , cohort , pharmacology , cancer , biology , gene , genetics , genotype , cytochrome p450 , metabolism
Meta‐analysis of the entire analyzable cohort of 4,935 tamoxifen‐treated breast cancer patients by the International Tamoxifen Pharmacogenetics Consortium (ITPC) (criterion 3) revealed no CYP2D6 effect on outcomes but strong heterogeneity across sites. 1 However, a post hoc –defined subgroup (criterion 1: postmenopausal, estrogen receptor positive, receiving 20 mg/day tamoxifen for 5 years; n = 1,996) did find a statistically significant effect of CYP2D6 on both invasive disease–free survival as well as breast cancer–free interval, with little site heterogeneity. How should we interpret these discrepant findings? “ Statistics: The only science that enables different experts using the same figures to draw different conclusions .” —Evan Esar, humorist “ Data do not give up their secrets easily. They must be tortured to confess .” —Jeffrey Hooper, Bell Laboratories “ Facts are stubborn, but statistics are more pliable .” —Mark Twain, humorist Clinical Pharmacology & Therapeutics (2014); 96 2, 144–146. doi: 10.1038/clpt.2014.100