2D6 Rears its ugly head…..


Ok, I have been to hell and back......but I am back.......

I am working on a video you all may soon love to hate, I am also working on a poster for GAPPNet which you too may also soon love to hate......

Well, for all you Amplichip fans, the data from a recent retrospective analysis of German and US cohorts reveals that null function 2D6 may actually portend a worse prognosis for those taking adjuvant (after surgery) chemotherapy for breast cancer. These are women who had hormone receptor positive breast cancer stages I-III, without metastases and without chermotherapy.

At 9 years of follow up, patients who had null 2D6 CYP 450 enzymes ended up with a 29% recurrence rate instead of those who had active 2D6 enzymes. This compared to 14.9% for extensive metabolizers.

Why does this matter?
1. Tamoxifen is used a lot
2. Aromatase inhibitor therapy (Another Drug) is another option for this type of cancer
3. This test is easy to do
4. This follows the Plavix model......

My guess, Roche is about to make a lot of money on the Amplichip shortly.......

Why is this study important? It is the first sufficiently powered study to assess 2D6 genotypes and outcomes.....

Even more importantly, Tamoxifen is a Pro-Drug.....just like Plavix. This time it requires conversion to Endoxifen which is the active drug derived from Tamoxifen.......

The hazard ration for recurrence with poor metabolizers is 2.12. That is a useful thing, which may prompt refined endocrine therapy for these postmenopausal breast cancers......

The Sherpa Says: I am back!!!

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