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Figure 2 | SpringerPlus

Figure 2

From: Concomitant use of tamoxifen and endoxifen in postmenopausal early breast cancer: prediction of plasma levels by physiologically-based pharmacokinetic modeling

Figure 2

Virtual clinical trial design. Study group A: 20 mg/day tamoxifen was simulated over a period of twelve months in CYP2D6 EMs, IMs, and PMs (N = 1,000 for each phenotype group). Study group B: tamoxifen dose escalation to 20 mg twice daily was simulated for four months followed by four months dosing of 20 mg/day tamoxifen in CYP2D6 IMs and PMs (N = 1,000, each). Tamoxifen dose escalation to 40 mg/day was simulated for four months followed by four months dosing of 20 mg/day tamoxifen in CYP2D6 IMs and PMs (N = 1,000, each). Only in CYP2D6 PMs, tamoxifen dose escalation of 60 mg/d was simulated for four months followed by four months dosing of 20 mg/day tamoxifen (N = 1,000). Study group C: 20 mg/d tamoxifen plus increasing endoxifen dosages were simulated in CYP2D6 IMs and PMs for a period of twelve months (N = 1,000, each). Abbreviations used in diagram: tamoxifen (TAM), cytochrome P450 2D6 (CYP2D6), extensive metabolizer (EM), intermediate metabolizer (IM), poor metabolizer (PM), once daily (q.d.), twice daily (b.d.), endoxifen (END).

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