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Chinese breast cancer patients with CYP2D6 *10 mutant genotypes have a better prognosis with toremifene than with tamoxifen
Author(s) -
Wang Hongyue,
Ma Xinchi,
Zhang Bin,
Zhang Yaotian,
Han Ning,
Wei Linlin,
Sun Chaonan,
Sun Shichen,
Zeng Xue,
Guo Hong,
Li Yubing,
Zhang Yanyu,
Zhao Jiaming,
Qin Zilan,
Liu Zhuang,
Zhang Na
Publication year - 2022
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.13571
Subject(s) - toremifene , tamoxifen , breast cancer , medicine , genotype , hazard ratio , antiestrogen , oncology , estrogen receptor , cancer , gastroenterology , biology , genetics , confidence interval , gene
Purpose To evaluate the prognosis of estrogen receptor‐positive breast cancer patients with CYP2D6*10 mutant genotypes under tamoxifen or toremifen therapy. Methods Estrogen receptor‐positive breast cancer patients were selected and CYP2D6*10 genotypes (C/C, C/T, and T/T) were determined by Sanger sequencing. Patients were divided into tamoxifen, toremifene, or tamoxifen + toremifene groups according to prior therapy. The correlation between CYP2D6*10 genotype and disease‐free survival was analyzed. Results In total, 293 estrogen receptor‐positive breast cancer patients treated with tamoxifen or toremifene between 2008 and 2017 were studied. Median follow‐up was 39 months (10–141). Of these, 107 (36.52%), 112 (38.23%), and 74 (25.26%) patients had C/C, C/T, and T/T genotypes, respectively. Genotype was significantly associated with disease‐free survival in tamoxifen patients. Patients with C/T and T/T genotypes showed worse disease‐free survival than patients with a C/C genotype. Genotype and disease‐free survival in toremifene and tamoxifen+toremifene patients were not correlated. Of patients with a C/T genotype, toremifene or tamoxifen+toremifene groups showed better disease‐free survival than tamoxifen patients. Although disease‐free survival of patients with a T/T genotype in the three groups was not statistically different, tamoxifen patients showed worse disease‐free survival. There was no correlation between different treatments and disease‐free survival in patients with a C/C genotype. Cox proportional hazard analysis revealed toremifene patients had a better prognosis than tamoxifen patients; toremifene was an independent protective factoremifene for disease‐free survival. Conclusions Tamoxifen was less effective in patients with CYP2D6*10 C/T and T/T genotypes. Estrogen receptor‐positive breast cancer patients with a CYP2D6*10 mutation genotype have a better prognosis with toremifen than tamoxifen.