Breast Cancer: Targets and Therapy (Oct 2020)
Breast Cancer and Tamoxifen: A Nigerian Perspective to Effective Personalised Therapy
Abstract
Ayorinde Adehin,1,2 Martin Alexander Kennedy,3 Julius Olugbenga Soyinka,1 Olusegun Isaac Alatise,4 Olalekan Olasehinde,4 Oluseye Oladotun Bolaji1 1Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Nigeria; 2Institute of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, People’s Republic of China; 3Department of Pathology and Biomedical Science; Carney Centre of Pharmacogenomics, University of Otago, Christchurch, New Zealand; 4Department of Surgery, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, NigeriaCorrespondence: Ayorinde Adehin Department of Pharmaceutical Chemistry, Faculty of PharmacyObafemi Awolowo University, Ile-Ife, NigeriaTel +234 8022013470Email [email protected]: Estrogen-receptor positivity in tumour, often requiring long-term tamoxifen therapy, is thought to characterise between 43% and 65% of breast cancer cases in Nigeria. The patient population is further marked by late-stage diagnosis which significantly heightens the tendency for tumour relapse in the course of tamoxifen therapy. Despite tamoxifen being considered a reliable chemopreventive in high-risk individuals and an effective adjuvant therapy for hormone-sensitive tumours, mortality has remained high among breast cancer patients in the West African region where Nigeria belongs. The Nigerian breast cancer population, like other similar patient-populations in the West African region, provides a mix of intrinsic genome-diversity and perhaps unique tumour biology and evolution. These peculiarities suggest the need for a rational approach to tumour management and a personalised delivery of therapy in Nigeria’s dominant estrogen-receptor-positive patient population. Herein, critical indices of tamoxifen-therapy success are discussed in the context of the Nigerian breast cancer population with emphasis on salient aspects of tamoxifen-biotransformation, host- and tumour-genomics, and epigenetics.Keywords: breast cancer, estrogen receptor, tamoxifen, Nigeria, epigenetics, genomics
