Breast Cancer Clinical Trial
Official title:
¹³C - Dextromethorphan (DM) Breath Test for Determination of CYP2D6 Enzyme Activity in Patients Receiving Tamoxifen
RATIONALE: A breath test that measures enzymes may be effective in identifying women in whom
tamoxifen may not be effective.
PURPOSE: This clinical trial is studying a breath test to see how well it works in women
receiving tamoxifen for the prevention or treatment of breast cancer.
OBJECTIVES:
- To assess the operating characteristics of the ¹³C-dextromethorphan (^13 C-DM) breath
test in identifying women with breast cancer (or at high risk) who are CYP2D6-genotypic
poor metabolizers.
- To examine the correlation between CYP2D6 enzyme activity (as measured by the breath
test) and plasma endoxifen (and 4-hydroxyTAM) levels in patients who carry one or more
CYP2D6 functional alleles.
- To examine the change in CYP2D6 enzyme activity (as measured by the ¹³C-DM breath test),
in patients who start a CYP2D6 inhibitor while taking tamoxifen.
- To determine whether CYP2D6 enzyme activity (as measured by the breath test) changes
over time (either as a consequence of drug-induced inhibition or other).
- To measure genetic variation in additional genes that are later identified to affect the
metabolism, uptake, or distribution of tamoxifen (e.g., SULT1A1, UGT).
OUTLINE: Patients receive tamoxifen citrate for 6 months. ^13C-dextromethorphan breath tests
are conducted at baseline and periodically during the 6 months.
13C-dextromethorphan breath test: Patients receive oral Alka-Seltzer® Gold (ASG; citric acid,
potassium bicarbonate, and sodium bicarbonate) in water, then, 15 minutes later, another ASG
dose and oral ¹³C-dextromethorphan. Patients breathe into a bag 1-2 times, and the is bag
sealed. ¹³CO_2 levels in the bags are measured.
Blood samples are collected at baseline and periodically for pharmacogenetic and
pharmacokinetic studies by reverse phase HPLC with fluorescence detection.
After completion of study therapy, patients are followed annually for 5 years.
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