Analisis Efektivitas Tamoxifen Berdasarkan Faktor Klinis, Genetik, dan Kepatuhan Pasien : Literature Review

Rizka Maulidiah; Cindy Marseli

doi:10.56359/pharmgen.v5i2.1151

Authors

Rizka Maulidiah Universitas Aisyiyah Palembang
Cindy Marseli Universitas Sriwijaya

DOI:

https://doi.org/10.56359/pharmgen.v5i2.1151

Keywords:

Kanker Payudara HR-positif, Kepatuhan Pasien, Resistensi Terapi, Tamoxifen, Terapi Endokrin

Abstract

Pendahuluan: Kanker payudara dengan reseptor hormon positif (HR+) merupakan subtipe yang paling banyak ditemukan, dengan terapi endokrin seperti tamoxifen dan aromatase inhibitors (AI) sebagai standar utama pengobatan. Meskipun efektif menurunkan risiko kekambuhan, keberhasilan terapi dipengaruhi oleh berbagai faktor, termasuk strategi pemberian obat, variasi genetik pasien, resistensi tumor, dan kepatuhan pasien. Polimorfisme gen CYP2D6, hilangnya ekspresi reseptor estrogen, serta ketidakpatuhan akibat efek samping menjadi tantangan utama dalam optimalisasi terapi. Selain itu, pemanfaatan biomarker klinis dan pendekatan pemantauan gejala secara aktif berpotensi mendukung terapi yang lebih efektif dan terpersonalisasi. Ulasan ini bertujuan mengevaluasi faktor-faktor yang memengaruhi keberhasilan terapi endokrin pada kanker payudara HR+ sebagai dasar pengembangan strategi penatalaksanaan yang lebih optimal dan terpersonalisasi.

Tujuan: Kajian literatur ini bertujuan mengevaluasi secara komprehensif seluruh determinan penentu keberhasilan terapi endokrin guna menyajikan landasan penatalaksanaan kanker payudara yang lebih mutakhir dan terpersonalisasi.

Metode: Penelitian ini dilakukan dengan metode checklist PRISMA menggunakan database PubMed.

Hasil: Kajian menunjukkan bahwa efektivitas tamoxifen dipengaruhi oleh strategi terapi, faktor genetik, status reseptor hormon, biomarker klinis, dan kepatuhan pasien. Strategi kombinasi, pengaturan waktu konsumsi, serta pemantauan gejala aktif dapat meningkatkan keberhasilan terapi, sedangkan resistensi tumor dan ketidakpatuhan pasien menjadi hambatan utama.

Kesimpulan: amoxifen efektif sebagai terapi kanker payudara HR-positif, terutama dalam menurunkan risiko kekambuhan. Efektivitasnya dipengaruhi oleh strategi terapi, faktor genetik, dan profil biologis pasien. Strategi peralihan ke AI serta konsumsi pada malam hari dapat meningkatkan keberhasilan terapi, sedangkan polimorfisme CYP2D6 dan hilangnya reseptor estrogen dapat memicu resistensi. Selain itu, rendahnya kepatuhan pasien akibat efek samping menjadi hambatan utama keberhasilan terapi. Oleh karena itu, diperlukan pendekatan terapi yang terpersonalisasi melalui pemilihan strategi pengobatan yang tepat, pengujian genetik, dan pemantauan gejala secara aktif untuk meningkatkan kepatuhan pasien.

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