Ariadne Genomics Inc. CYP3A4 SULT1A1 4-OH-TAM UGTs endoxifen UGTs endoxifen CYPs 4-OH-TAM CYPs DMT CYPs ABCB1 Sult2a1 Cyp3a2 tamoxifen ---> DMT PAPS(2) UDPGA 4-OH-TAM ---> 4-OH-TAM-gluc PAPS(1) ---> alpha-OH-TAM-S tamoxifen ---> alpha-OH-TAM tamoxifen ---> 4-OH-TAM 4-OH-TAM ---> endoxifen UDPGA ---> endoxifen-gluc alpha-OH-TAM ---> alpha-OH-TAM-S alpha-OH-TAM-S ---> DNA adducts endoxifen elimination endoxifen ---> endoxifen elimination PAPS(2) ---> 4-OH-TAM-S UDPGA ---> 4-OH-TAM-gluc endoxifen ---> endoxifen-gluc DMT ---> endoxifen 4-OH-TAM ---> 4-OH-TAM-S 4-OH-TAM-gluc endoxifen-gluc hSULT2A1 DMT alpha-OH-TAM PAPS(1) alpha-OH-TAM-S DNA adducts endoxifen 4-OH-TAM 4-OH-TAM-S tamoxifen