临床药师基于CYP2D6基因检测指导他莫昔芬个体化用药及其疗效评价

Guiding individual medication therapy of tamoxifen through CYP2D6 genotyping test by clinical pharmacists

目的:临床药师利用CYP2D6基因检测指导他莫昔芬个体化用药。方法:选取某院2016年3月至2020年7月就诊的168例乳腺癌患者,采用荧光原位杂交技术测定患者的基因型,临床药师根据基因类型为患者制定个体化用药建议。对于正常代谢型患者,建议他莫昔芬20 mg·d-1;对于中间代谢型患者,建议予他莫昔芬40 mg·d-1。结果:在168例患者中,基因检测结果显示,正常代谢型患者131例,占77.98%;中间代谢型患者37例,占22.02%。结论:临床药师基于CYP2D6基因检测可以指导他莫昔芬个体化用药。对于中间代谢型患者,乳腺癌复发率高于正常代谢型患者。

OBJECTIVE To employ the test of CYP2 D6 gene polymorphism to guide individualized medication of tamoxifen.METHODS From March 2016 to July 2017,a total of 168 patients with clinical CYP2 D6 genotyping test of tamoxifen were enrolled.Clinical pharmacists tested the genotypes by fluorescence in situ hybridization.Individualized medications were adjusted according to patient genotypes.For extensive metabolizers, an initial dose of 20 mg·d-1 was recommended;For intermediate metabolizers, a higher dose of tamoxifen dose(40 mg·d-1)was adopted.RESULTS Among them, there were 131 extensive metabolizers(77.98%)and 37 intermediate metabolizers(22.02%).CONCLUSION Clinical pharmacists may guide individualized medication according to CYP2 D6 gene polymorphism.A higher recurring risk of breast cancer is associated with extensive metabolizers.