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Medwid S, Schwarz UI, Choi YH, Keller D, Ross C, Kim RB. Solanidine Metabolites as Diet-Derived Biomarkers of CYP2D6-Mediated Tamoxifen Metabolism in Breast Cancer Patients. Clin Pharmacol Ther 2024. [PMID: 39039708 DOI: 10.1002/cpt.3380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 07/08/2024] [Indexed: 07/24/2024]
Abstract
Tamoxifen is an important antiestrogen for the treatment of hormone receptor-positive breast cancer and undergoes bioactivation by CYP2D6 to its active metabolite endoxifen. Genetic variation in CYP2D6 has been linked to endoxifen levels during tamoxifen therapy. Recent studies have suggested solanidine, a glycoalkaloid phytochemical in potatoes, undergoes CYP2D6-mediated metabolism to 4-OH-solanidine (m/z 414) and 3,4-seco-solanidine-3,4-dioic acid (SSDA; m/z 444). Using a retrospective cohort of 1,032 breast cancer patients on tamoxifen therapy, we examined the association of solanidine metabolites with CYP2D6 activity and its correlation with tamoxifen metabolism. Solanidine, 4-OH-solanidine, or SSDA was detected in 99.7% (N = 1,029) of plasma samples. Decreased solanidine metabolite ratios were found in CYP2D6 intermediate and poor metabolizers (P < 0.0001). Patients on CYP2D6 strong inhibitors had a 77.6% and 94.2% decrease in 4-OH-solandine/solanidine (P < 0.0001) and SSDA/solanidine (P < 0.0001), respectively. The ratio of endoxifen to tamoxifen was highly correlated with both 4-OH-solandine/solanidine (ρ = 0.3207, P < 0.0001) and SSDA/solanidine (ρ = 0.5022, P < 0.0001) ratios. Logistic regression modeling was used to determine that 4-OH-solanidine/solanidine and SSDA/solanidine ratios below 2.1 and 0.8, respectively, predicted endoxifen concentrations of <16 nM. In conclusion, solanidine, 4-OH-solanidine, and SSDA are diet-derived biomarkers of CYP2D6 activity. Moreover, in patients on tamoxifen therapy, 4-OH-solanidine/solanidine and SSDA/solanidine predicted endoxifen levels including the inhibitory effects of concomitantly prescribed CYP2D6-interacting medications. Accordingly, 4-OH-solanidine/solanidine or SSDA/solanidine ratio has the potential to be particularly useful prior to initiation of tamoxifen or for determining the impact of CYP2D6 drug interactions, as well as prior to switching from an aromatase inhibitor to tamoxifen.
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Affiliation(s)
- Samantha Medwid
- Department of Medicine, Western University, London, Ontario, Canada
| | - Ute I Schwarz
- Department of Medicine, Western University, London, Ontario, Canada
- Department of Physiology and Pharmacology, Western University, London, Ontario, Canada
| | - Yun-Hee Choi
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Denise Keller
- London Health Sciences Centre, London, Ontario, Canada
| | - Cameron Ross
- Department of Medicine, Western University, London, Ontario, Canada
| | - Richard B Kim
- Department of Medicine, Western University, London, Ontario, Canada
- Department of Physiology and Pharmacology, Western University, London, Ontario, Canada
- London Health Sciences Centre, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
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Maximov PY, Abderrahman B, Fanning SW, Sengupta S, Fan P, Curpan RF, Rincon DMQ, Greenland JA, Rajan SS, Greene GL, Jordan VC. Endoxifen, 4-Hydroxytamoxifen and an Estrogenic Derivative Modulate Estrogen Receptor Complex Mediated Apoptosis in Breast Cancer. Mol Pharmacol 2018; 94:812-822. [PMID: 29739819 PMCID: PMC6022805 DOI: 10.1124/mol.117.111385] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 05/04/2018] [Indexed: 12/17/2022] Open
Abstract
Estrogen therapy was used to treat advanced breast cancer in postmenopausal women for decades until the introduction of tamoxifen. Resistance to long-term estrogen deprivation (LTED) with tamoxifen and aromatase inhibitors used as a treatment of breast cancer inevitably occurs, but unexpectedly low-dose estrogen can cause regression of breast cancer and increase disease-free survival in some patients. This therapeutic effect is attributed to estrogen-induced apoptosis in LTED breast cancer. Here, we describe modulation of the estrogen receptor (ER) liganded with antiestrogens (endoxifen and 4-hydroxytamoxifen) and an estrogenic triphenylethylene (TPE), ethoxytriphenylethylene (EtOXTPE), on estrogen-induced apoptosis in LTED breast cancer cells. Our results show that the angular TPE estrogen (EtOXTPE) is able to induce the ER-mediated apoptosis only at a later time compared with planar estradiol in these cells. Using real-time polymerase chain reaction, chromatin immunoprecipitation, western blotting, molecular modeling, and X-ray crystallography techniques, we report novel conformations of the ER complex with an angular estrogen EtOXTPE and endoxifen. We propose that alteration of the conformation of the ER complexes, with changes in coactivator binding, governs estrogen-induced apoptosis through the protein kinase regulated by RNA-like endoplasmic reticulum kinase sensor system to trigger an unfolded protein response.
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Affiliation(s)
- Philipp Y Maximov
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.Y.M., B.A., P.F., D.M.Q.R., J.A.G., V.C.J.); The Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois (S.W.F., S.S.R., G.L.G.); Department of Oncology, Lombardi Comprehensive Cancer Center, Washington, DC (S.S.); and Institute of Chemistry, Romanian Academy, Timisoara, Romania (R.F.C.)
| | - Balkees Abderrahman
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.Y.M., B.A., P.F., D.M.Q.R., J.A.G., V.C.J.); The Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois (S.W.F., S.S.R., G.L.G.); Department of Oncology, Lombardi Comprehensive Cancer Center, Washington, DC (S.S.); and Institute of Chemistry, Romanian Academy, Timisoara, Romania (R.F.C.)
| | - Sean W Fanning
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.Y.M., B.A., P.F., D.M.Q.R., J.A.G., V.C.J.); The Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois (S.W.F., S.S.R., G.L.G.); Department of Oncology, Lombardi Comprehensive Cancer Center, Washington, DC (S.S.); and Institute of Chemistry, Romanian Academy, Timisoara, Romania (R.F.C.)
| | - Surojeet Sengupta
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.Y.M., B.A., P.F., D.M.Q.R., J.A.G., V.C.J.); The Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois (S.W.F., S.S.R., G.L.G.); Department of Oncology, Lombardi Comprehensive Cancer Center, Washington, DC (S.S.); and Institute of Chemistry, Romanian Academy, Timisoara, Romania (R.F.C.)
| | - Ping Fan
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.Y.M., B.A., P.F., D.M.Q.R., J.A.G., V.C.J.); The Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois (S.W.F., S.S.R., G.L.G.); Department of Oncology, Lombardi Comprehensive Cancer Center, Washington, DC (S.S.); and Institute of Chemistry, Romanian Academy, Timisoara, Romania (R.F.C.)
| | - Ramona F Curpan
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.Y.M., B.A., P.F., D.M.Q.R., J.A.G., V.C.J.); The Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois (S.W.F., S.S.R., G.L.G.); Department of Oncology, Lombardi Comprehensive Cancer Center, Washington, DC (S.S.); and Institute of Chemistry, Romanian Academy, Timisoara, Romania (R.F.C.)
| | - Daniela Maria Quintana Rincon
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.Y.M., B.A., P.F., D.M.Q.R., J.A.G., V.C.J.); The Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois (S.W.F., S.S.R., G.L.G.); Department of Oncology, Lombardi Comprehensive Cancer Center, Washington, DC (S.S.); and Institute of Chemistry, Romanian Academy, Timisoara, Romania (R.F.C.)
| | - Jeffery A Greenland
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.Y.M., B.A., P.F., D.M.Q.R., J.A.G., V.C.J.); The Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois (S.W.F., S.S.R., G.L.G.); Department of Oncology, Lombardi Comprehensive Cancer Center, Washington, DC (S.S.); and Institute of Chemistry, Romanian Academy, Timisoara, Romania (R.F.C.)
| | - Shyamala S Rajan
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.Y.M., B.A., P.F., D.M.Q.R., J.A.G., V.C.J.); The Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois (S.W.F., S.S.R., G.L.G.); Department of Oncology, Lombardi Comprehensive Cancer Center, Washington, DC (S.S.); and Institute of Chemistry, Romanian Academy, Timisoara, Romania (R.F.C.)
| | - Geoffrey L Greene
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.Y.M., B.A., P.F., D.M.Q.R., J.A.G., V.C.J.); The Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois (S.W.F., S.S.R., G.L.G.); Department of Oncology, Lombardi Comprehensive Cancer Center, Washington, DC (S.S.); and Institute of Chemistry, Romanian Academy, Timisoara, Romania (R.F.C.)
| | - V Craig Jordan
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (P.Y.M., B.A., P.F., D.M.Q.R., J.A.G., V.C.J.); The Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois (S.W.F., S.S.R., G.L.G.); Department of Oncology, Lombardi Comprehensive Cancer Center, Washington, DC (S.S.); and Institute of Chemistry, Romanian Academy, Timisoara, Romania (R.F.C.)
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