RATIONALE: Estrogen can promote growth of endocrine sensitive breast cancer cells. Endocrine therapy with tamoxifen citrate may fight breast cancer by blocking the use of estrogen by the tumor cells. Pharmacokinetics and -genomics can have an impact on the efficacy of the treatment. PURPOSE: This phase III trial is studying blood samples to see if the level of active metabolites of tamoxifen can be improved in patients with breast cancer.
OBJECTIVES: Primary * To determine how the increase of tamoxifen citrate dose influences the level of its major metabolites in patients with hormone-sensitive breast cancer. Secondary * To characterize the population pharmacokinetic profile * To investigate the role of the other CYPs * To assess the relation between clinical symptoms and CYP2D6 genotypes and/or active metabolites levels * To explore the correlation between genotypes/metabolites levels and clinical outcomes in terms of tumor relapse. * To assess the feasibility, efficacy, and safety of concentration-guided adjustment of tamoxifen citrate dosage. * To conduct other exploratory analysis based on the eventual new data coming up in the future. OUTLINE: Patients receive oral tamoxifen citrate (at a dose of 40 mg/day) daily for 4 months in the absence of disease progression or unacceptable toxicity. Blood samples are collected for PK, genotyping, phenotyping, and further analysis.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
140
Hôpitaux Universitaire de Genève
Geneva, Switzerland
RECRUITINGCentre Hospitalier Universitaire Vaudois
Lausanne, Switzerland
RECRUITINGDetermination of CYP2D6 genotype and determination of plasma concentrations of tamoxifen citrate and its metabolites (N-desmethyl-tamoxifen, 4-hydroxy-tamoxifen and endoxifen) under the 20 mg daily and 40 mg daily schedules
Time frame: Jan 2013
Patients' characteristics
Time frame: prospectively
Tumor characteristics
Time frame: prospectively
Cancer treatments history
Time frame: prospectively
CYP3A4 (phenotype), and possibly other cytochromes involved in the metabolism and transport of drugs
Time frame: prospectively
Characteristics of drug intake (date of tx initiation, current dosage and frequency, time of last intake) along with patient-reported adherence, assessed by questionnaire
Time frame: prospectively
Concomitant medication
Time frame: prospectively
Presence and quantitation of clinical symptoms
Time frame: prospectively
Detection and classification of general comorbidities and side effects according to NCI-CTC v3.0
Time frame: prospectively
Detection of tumor relapse during the observation period of the study
Time frame: prospectively
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