Personalized Cancer Care Off to Slow Start (Questions Tamoxifen CYP2D6 testing)

[Rich66]

http://www.gooznews.com/node/3250

With the cost of new cancer drugs soaring to $10,000 a month or more, genomic analyses of cancer tumors hold out the hope that oncologists will be able to identify in advance which patients will benefit from use of pricey new drugs. A new draft report from the Agency for Healthcare Research and Quality suggests that day is still a ways off.
In the finding most likely to cause controversy, the AHRQ report found there was "no consistent associations" between breast cancer patients with the relevant CYP2D6 polymorphism and the outcome of tamoxifen therapy, whether as primary treatment or in as post-operative adjuvant therapy. Estimates vary, but anywhere from 10 to 40 percent of women have the gene variant of CYP2D6 that is believed to slow the metabolism of tamoxifen and make it less effective. A number of companies sell a $300 test that can show if women have the allegedly telltale CYP2D6 polymorphism.
As is often the case, the 13 studies identified by the systematic review didn't contain enough data to draw definitive conclusions. "Most studies were relatively small and thus underpowered to detect what would be a plausible effect size for the modification of response to tamoxifen by a single polymorphism," the report noted.

[Rich66]

and then....a new Tamoxifen marker:

LINK

Discovery could aid cancer care
(UKPA) – 6 hours ago
A new gene discovery could lead to more personalised treatment for breast cancer patients, scientists announced.
Experts have identified a gene, FKBPL, which predicts how women will respond to the commonly used drug tamoxifen.
The medicine interferes with the activity of the female hormone oestrogen, and is suitable for women with hormone sensitive breast cancer.
About 28,000 women in the UK are diagnosed with this type of cancer each year and thousands are given tamoxifen for five years after an initial round of treatment or surgery.
However, not all women respond to the drug and it is estimated that only around two-thirds actually benefit.
Now, scientists at Queen's University Belfast have found that high levels of FKBPL in breast cancer cells suggest a woman will respond well to tamoxifen and have a better chance of survival than women with low levels of the gene.
Tracy Robson and Hayley McKeen published the study, funded by the charity Breast Cancer Campaign, in the journal Cancer Research.
Dr Robson said: "I believe that many women are being treated with tamoxifen without knowing whether it will benefit them.
"This research is a step in the right direction towards personalised treatment, ensuring that appropriate therapies are given right at the point of diagnosis, avoiding unnecessary treatment.
"More importantly this research should allow us to identify which patients are unlikely to respond to or eventually relapse on tamoxifen therapy, which means they could be treated more aggressively with chemotherapy."