SSRI during tamoxifen therapy impairs CYP2D6 enzyme function and may lead to decreased tamoxifen efficacy and inferior clinical outcome 30, 47, 49 51 DNA source Observed genotype frequencies of PM alleles displayed exaggerated HWE deviation in DNA samples extracted from tumors possibly due to genotype misclassifications and may be attributable to well known hemizygous deletions of CYP2D6 in breast cancer tissue LOH 54, 57 59 Genotyping coverage Insufficient CYP2D6 genotyping coverage can lead to phenotype misclassification affecting its ability to predict outcome 40, 61
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