CYP2D6基因检测在他莫昔芬治疗乳腺癌中的应用

Application of CYP2D6 gene detection in tamoxifen in treatment of breast cancer

目的分析CYP2D6基因检测在他莫昔芬治疗乳腺癌患者时的应用价值。方法回顾性分析2019年8月于广州医科大学附属第三医院接受他莫昔芬内分泌辅助治疗的11例女性乳腺癌患者临床资料。依据CYP2D6基因型检测结果为临床提供用药决策,从而阐明CYP2D6酶基因检测的重要意义。结果患者基因型总体分为:CYP2D6*10/*10中间代谢型(IM)、CYP2D6*1/*10快代谢型(EM)及CYP2D6*2/*10快代谢型(EM)。CYP2D6*10/*10中间代谢型(IM)其CYP2D6酶活性降低,可考虑使用更高剂量他莫昔芬(40 mg/d);后两种基因型的CYP2D6酶活性正常,他莫昔芬活性代谢产物生成正常,可采用推荐的剂量标准(他莫昔芬,20 mg/d)进行治疗。结论借助基因检测结果,为他莫昔芬的临床应用剂量提供指导,以避免达不到治疗效果。CYP2D6基因多态性与他莫昔芬的临床疗效密切相关,基因检测对临床用药具有重要意义。

Objective To analyze the value of CYP2D6 gene detection in tamoxifen in the treatment of breast cancer patients.Methods The clinical data of 11 women with breast cancer who received adjuvant therapy with tamoxifen in the Third Affiliated Hospital of Guangzhou Medical University in August 2019 were retrospectively analyzed.Based on the results of CYP2D6 genotype detection,this paper provides drug decision-making for clinic,so as to clarify the significance of CYP2D6 enzyme gene detection.Results The genotypes of patients were divided into CYP2D6*10/*10 intermediate metabolic type(IM),CYP2D6*1/*10 fast metabolic type(EM)and CYP2D6*2/*10 fast metabolic type(EM).CYP2D6*10/*10 intermediate metabolic type(IM)has decreased CYP2D6 enzyme activity,so a higher dose of tamoxifen(40 mg/d)can be considered.The CYP2D6 enzyme activity of the latter two genotypes is normal,and the production of tamoxifen active metabolites is normal.They can be treated with the recommended dose standard(tamoxifen,20 mg/d).Conclusion With the help of gene test results,it can provide guidance for the clinical application dose of tamoxifen,so as to avoid failing to achieve the therapeutic effect.CYP2D6 gene polymorphism is closely related to the clinical efficacy of tamoxifen.Gene detection is of great significance for clinical medication.