Drug–drug interactions in oncology: Why are they important and can they be minimized?

Blower, P. R.; Wit, Ronald de; Goodin, Susan; Aapro, Matti

doi:10.1016/j.critrevonc.2005.03.007

Cited by 163 publications

(101 citation statements)

References 123 publications

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“…The risk of drugdrug interactions, however, increases with the number of concomitantly administered medication [1]. A signiWcant part of these drug-drug interactions are pharmacokinetic interactions [2,3].…”

Section: Introductionmentioning

confidence: 99%

Nuclear receptor mediated induction of cytochrome P450 3A4 by anticancer drugs: a key role for the pregnane X receptor

Harmsen

Meijerman

Beijnen

et al. 2008

Cancer Chemother Pharmacol

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Purpose Induction of cytochrome P450 (CYP) 3A4, an enzyme that is involved in the biotransformation of more than 50% of all drugs, by xenobiotics is an important cause of pharmacokinetic drug-drug interactions in oncology. In addition to rifampicin and hyperforin, the anticancer drug paclitaxel has also been shown to be an inducer of CYP3A4 via activation of the pregnane X receptor (PXR). We therefore screened 18 widely used anticancer drugs for their ability to activate PXR-mediated CYP3A4 induction. Methods A CYP3A4 reporter gene assay was employed to identify PXR agonists among the eighteen anticancer drugs. Subsequently CYP3A4 mRNA and protein expression following treatment with these PXR agonists was assessed. Finally, the eVect of pre-treatment with these agents on the 1'-hydroxylation of midazolam (a speciWc CYP3A4 probe) was determined. Results Paclitaxel, erlotinib, tamoxifen, ifosfamide, Xutamide and docetaxel are able to activate PXR, while only strong PXR activation leads to signiWcant induction of CYP3A4 activity. Conclusions The identiWed PXR agonists may have the propensity to cause clinically relevant drug-drug interactions as a result of CYP3A4 induction.

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Section: Introductionmentioning

confidence: 99%

Nuclear receptor mediated induction of cytochrome P450 3A4 by anticancer drugs: a key role for the pregnane X receptor

Harmsen

Meijerman

Beijnen

et al. 2008

Cancer Chemother Pharmacol

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“…64 Drug-to-drug interactions can lead to adverse clinical outcomes, particularly in oncology, because of the narrow antineoplastic index of oral agents and a high risk of additional medications prescribed for age-related organ dysfunction. 65,66 Not all drug-drug interactions can be predicted, and those that are predictable are not always avoidable. However, increased awareness of the potential for these interactions will allow healthcare providers to minimize the risk by choosing appropriate drugs and by monitoring for signs of interaction.…”

Section: Complexity Of the Dosing Regimenmentioning

confidence: 99%

“…However, increased awareness of the potential for these interactions will allow healthcare providers to minimize the risk by choosing appropriate drugs and by monitoring for signs of interaction. 66 …”

Section: Complexity Of the Dosing Regimenmentioning

confidence: 99%

The Challenges of Oral Agents as Antineoplastic Treatments

Given

Spoelstra²,

Grant³

2011

Seminars in Oncology Nursing

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“…Comorbidities and associated polypharmacy can lead to adverse clinical outcomes, and it may be difficult to assess and measure the difference between outcomes related to polypharmacy and symptoms or adverse events related to the oral agent. [89][90][91] Finally, adherence correlates with patients' beliefs in the severity of the disease to be prevented or treated, [92][93][94] and there are some tools (i.e., BMQ)…”

Section: Patient Characteristics Contributing To Adherence and Implicmentioning

confidence: 99%

Assessment and Measurement of Adherence to Oral Antineoplastic Agents

Spoelstra¹,

Given²

2011

Seminars in Oncology Nursing

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OBJECTIVES:The increase in oral anticancer medications with complex regimens creates a need to assure patients are taking therapeutic dosages as prescribed. This article reviews the assessment and measurement of adherence to oral antineoplastic agents. DATA SOURCE:Research and journal articles from CINAHL and Pub Med. CONCLUSION:Assessing and measuring adherence to oral antineoplastic should include three dimensions: the percentage of medications taken, the duration, and the timing of taking the medication. IMPLICATIONS FOR PRACTICE:Clinicians need to conduct ongoing assessment and measurement of adherence to oral antineoplastic agents. This includes eliciting patient report of adherence, pill counts, drug diaries, and pharmacy or medical record audits.

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Drug–drug interactions in oncology: Why are they important and can they be minimized?

Cited by 163 publications

References 123 publications

Nuclear receptor mediated induction of cytochrome P450 3A4 by anticancer drugs: a key role for the pregnane X receptor

Nuclear receptor mediated induction of cytochrome P450 3A4 by anticancer drugs: a key role for the pregnane X receptor

The Challenges of Oral Agents as Antineoplastic Treatments

Assessment and Measurement of Adherence to Oral Antineoplastic Agents

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