Pharmacogenomics and Personalized Medicine (Feb 2021)
Enriching Medication Review with a Pharmacogenetic Profile – A Case of Tamoxifen Adverse Drug Reactions
Abstract
Chiara Jeiziner,1 Céline K Stäuble,1,2 Markus L Lampert,1 Kurt E Hersberger,1 Henriette E Meyer zu Schwabedissen2 1Pharmaceutical Care Research Group, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; 2Biopharmacy, Department of Pharmaceutical Sciences, University of Basel, Basel, SwitzerlandCorrespondence: Chiara JeizinerPharmaceutical Care Research Group; University of Basel, Petersplatz 14, Postfach 2148, Basel, 4001, SwitzerlandTel +41 61 207 61 80Email [email protected]: Pharmacogenotyping is applied to determine the hereditable component of a patient’s susceptibility to experience therapy failure and/or adverse drug reactions (ADRs). We present the case of a female patient diagnosed with breast cancer and treated with tamoxifen as recurrence therapy who experienced various ADRs. Pharmacogenotyping revealed variants in the cytochrome P450 (CYP) enzymes CYP2D6, CYP2C9, and CYP2C19. The observed genotype was associated with a risk for lower tamoxifen efficacy. Aside from the tamoxifen therapy, the comedication was reviewed for the influence of the patient’s pharmacogenetic profile. As a result of this pharmacist-led medication review with pharmacogenetic analyses, concrete genotype-driven recommendations for the treating gynecologist were compiled. This case revealed the added value of a large pharmacogenetic panel and the complexity of integrating a pharmacogenetic profile into a recommendation.Keywords: pharmacogenetics, PGx, CYP2D6, CYP2C9, CYP2C19, medication review, tamoxifen
