What is your approach to tamoxifen use in women who are unable to discontinue a strong CYP2D6 inhibitor and who are unable to use or tolerate an AI?

Topics: Breast Cancer • Medical Oncology • HR+

Answer from: Medical Oncologist at Academic Institution

I ran into this very situation not too long ago. In dealing with the situation, I asked myself the following questions: 1) Did I speak to prescribing psychiatrist or psychopharmacologist (or if I was the prescriber or primary care provider refer to a more experienced physician?) 2) Did I do everythi...

Comments

Medical Oncologist at Vince Lombardi Cancer Clinic
I am not aware of any data that demonstrates decre...

Medical Oncologist at VanDeusen Oncology Consulting
I completely agree. I feel there is still contradi...

Medical Oncologist at H Lee Moffitt Cancer Center, University of South Florida
This is a good discussion and the retrospective da...

Answer from: Medical Oncologist at Academic Institution

There is data supporting the equivalency of toremifene in the adjuvant setting (Lewis et al., PMID 20209619). Since it is mostly metabolized through CYP3A4, it may be a good choice in this case.

Comments

Medical Oncologist at Breastlink Medical Group
Or raloxifene.

Medical Oncologist at Icahn School of Medicine at Mount Sinai
I would stay away from raloxifene. That is approve...

Medical Oncologist at H Lee Moffitt Cancer Center, University of South Florida
Agree, would not use raloxifene outside chemopreve...

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