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Enriching Medication Review with a Pharmacogenetic Profile – A Case of Tamoxifen Adverse Drug Reactions

Authors Jeiziner C, Stäuble CK, Lampert ML, Hersberger KE, Meyer zu Schwabedissen HE

Received 15 October 2020

Accepted for publication 11 January 2021

Published 19 February 2021 Volume 2021:14 Pages 279—286


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Martin Bluth

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, Switzerland

Correspondence: Chiara Jeiziner
Pharmaceutical Care Research Group; University of Basel, Petersplatz 14, Postfach 2148, Basel, 4001, Switzerland
Tel +41 61 207 61 80

Abstract: 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

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