David A. Flockhart

School of Medicine, Medicine, Clinical Pharmacology

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David A. Flockhart

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Estrogen receptor genotypes, menopausal status, and the lipid effects of tamoxifen

N.I. Ntukidem; A.T. Nguyen; V. Stearns; M. Rehman; A. Schott; T. Skaar; Y. Jin; P. Blanche; L. Li; S. Lemler; et al. (Profiled Authors: Lang Li; Zeruesenay Desta; David A. Flockhart; Todd C. Skaar)

Clinical Pharmacology and Therapeutics. 2008;83(5):702-710.

Abstract

Tamoxifen induces important changes in serum lipid profiles in some women; however, little information is available to predict which women will experience improved lipid profiles during tamoxifen therapy. As part of a multicenter prospective observational trial in 176 breast cancer patients, we tested the hypothesis that tamoxifen-induced lipid changes were associated with genetic variants in candidate target genes (CYP2D6, ESR1, and ESR2). Tamoxifen lowered low-density lipoprotein cholesterol (P<0.0001) by 23.5 mg/dl (13.5-33.5 mg/dl) and increased triglycerides (P=0.006). In postmenopausal women, the ESR1-XbaI and ESR2-02 genotypes were associated with tamoxifen-induced changes in total cholesterol (P=0.03; GG vs GA/AA) and triglycerides (P=0.01; gene-dose effect), respectively. In premenopausal women, the ESR1-XbaI genotypes were associated with tamoxifen-induced changes in triglycerides (P=0.002; gene-dose effect) and high-density lipoprotein (P=0.004; gene-dose effect). Our results suggest that estrogen receptor genotyping may be useful in predicting which women would benefit more from tamoxifen. © 2007 American Society for Clinical Pharmacology and Therapeutics.


PMID: 17713466     PMCID: PMC2782693

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