A systematic review on drug interactions in oncology

OBJECTIVES

To systematically review drug interactions in oncology.

METHODS

We searched PubMed for eligible articles and online databases abstracts of major oncology meetings from 2002 to 2005.

RESULTS

One study reported on the frequency of drug interactions. Interactions between chemotherapy and nonchemotherapy agents have been reported mostly in small clinical trials and case series. Interactions between chemotherapic agents have been reported mostly in Phase I studies. Few studies described fatal outcomes of drug interactions in cancer patients.

CONCLUSION

Drug interactions comprise an important issue in oncology, but very limited data exist on their frequency and clinical consequences.

Interactions between anticancer drugs and other clinically used pharmaceuticals. A review

Drug interactions are increasingly common, since clinical practice is getting more complex with the flood of new drugs. Simultaneously, the increased life expectancy of the population increases the number of individuals likely to receive multiple prescriptions. Cytotoxic drugs generally have a narrow therapeutic index, and are delivered at doses close to toxic levels. Consequently, a slight increase in biological activity caused by an interaction with other concomitantly administered drugs could be deleterious to the patient. Interactions between drugs can sometimes also be used in a positive way, i.e. to increase the therapeutic ratio and overcome drug resistance. Interactions between different cancer treatment modalities have attracted considerable interest. However, much less interest has been devoted to interactions between anticancer drugs and other pharmaceuticals. The purpose of this review is to summarize data about the interactions between anticancer drugs and other clinically used drugs with regard to effects on tumor and toxicity.

Clinical management of cytotoxic drug overdose

In this article the pharmacological management of accidental drug overdose is discussed, with various treatments for overdose proposed, as supported by clinical facts and speculation. Current knowledge is outlined concerning dacarbazine, nitrosourea compounds, melphalan, procarbazine, cyclophosphamide, VP-16.213, l-asparaginase (colaspase), 6-mercaptopurine, mustine (nitrogen mustard), intravenous or intrathecal methotrexate (amethopterin), cytarabine (cytosine arabinoside), fluorouracil and bleomycin.