A mechanistic hypothesis for DNA adduct formation by tamoxifen following hepatic oxidative metabolism.

A mechanism for the generation of electrophilic alkylating agents from tamoxifen by hepatic alpha-oxidation of its ethyl group is presented which accounts for the formation of covalent DNA adducts associated with its hepatic carcinogenicity. The key process leading to the generation of electrophilic alkylating agents from tamoxifen is postulated to be alpha-hydroxylation in conjunction with 4-hydroxylation or secondary metabolic conjugation. The mechanism explains the lack of DNA adducts observed for the tamoxifen analogues toremifene, droloxifene and idoxifene and accounts for the species variation in hepatic carcinogenicity of tamoxifen.