Breast Cancer and Tamoxifen: A Nigerian Perspective to Effective Personalised Therapy

• Main Authors: Adehin A, Kennedy MA, Soyinka JO, Alatise OI, Olasehinde O, Bolaji OO
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-10-01
• Series: Breast Cancer : Targets and Therapy
• Subjects: breast cancer; estrogen receptor; tamoxifen; nigeria; epigenetics; genomics
• Online Access: https://www.dovepress.com/breast-cancer-and-tamoxifen-a-nigerian-perspective-to-effective-person-peer-reviewed-article-BCTT

Ayorinde Adehin,1,2 Martin Alexander Kennedy,3 Julius Olugbenga Soyinka,1 Olusegun Isaac Alatise,4 Olalekan Olasehinde,4 Oluseye Oladotun Bolaji1 1Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Nigeria; 2Institute of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, People’s Republic of China; 3Department of Pathology and Biomedical Science; Carney Centre of Pharmacogenomics, University of Otago, Christchurch, New Zealand; 4Department of Surgery, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, NigeriaCorrespondence: Ayorinde Adehin Department of Pharmaceutical Chemistry, Faculty of PharmacyObafemi Awolowo University, Ile-Ife, NigeriaTel [phone]Email [e-mail]: Estrogen-receptor positivity in tumour, often requiring long-term tamoxifen therapy, is thought to characterise between 43% and 65% of breast cancer cases in Nigeria. The patient population is further marked by late-stage diagnosis which significantly heightens the tendency for tumour relapse in the course of tamoxifen therapy. Despite tamoxifen being considered a reliable chemopreventive in high-risk individuals and an effective adjuvant therapy for hormone-sensitive tumours, mortality has remained high among breast cancer patients in the West African region where Nigeria belongs. The Nigerian breast cancer population, like other similar patient-populations in the West African region, provides a mix of intrinsic genome-diversity and perhaps unique tumour biology and evolution. These peculiarities suggest the need for a rational approach to tumour management and a personalised delivery of therapy in Nigeria’s dominant estrogen-receptor-positive patient population. Herein, critical indices of tamoxifen-therapy success are discussed in the context of the Nigerian breast cancer population with emphasis on salient aspects of tamoxifen-biotransformation, host- and tumour-genomics, and epigenetics.Keywords: breast cancer, estrogen receptor, tamoxifen, Nigeria, epigenetics, genomics