Association between Concomitant Use of Hydrochlorothiazide and Adverse Chemotherapy-Related Events among Older Women with Breast Cancer Treated with Cyclophosphamide

Determination of drug-drug interaction in breast cancer patients receiving doxorubicin and cyclophosphamide regimen

INTRODUCTION

Drug interactions constitute a significant issue in cancer treatment. Therefore, it is important to assess and analyze all cancer patients' therapies prior to the initiation of chemotherapy.

METHODS

A retrospective observational study was conducted at the Near East University Hospital Oncology Department located in North Cyprus between June 2019 and December 2021. The aim of the study was to determine the nature, type, and frequency of potential drug-drug interactions in breast cancer patients receiving a doxorubicin and cyclophosphamide regimen using Drugs.com, Lexicomp, and Micromedex databases while comparing the three electronic databases, according to the frequency, mechanism, and severity of drug-drug interactions.

RESULTS

The study included 40 patients (44.4%) out of 90 patients diagnosed with breast cancer, as 50 patients (55.6%) who did not match the criteria were excluded. According to the Lexicomp database, 12 patients (30%) with breast cancer had 14 potential drug-drug interactions, according to the Drugs.com database, 15 patients (37.5%) with breast cancer had 22 potential drug-drug interactions, and according to the Micromedex database, 13 patients (32.5%) with breast cancer had 15 potential drug-drug interactions. Pearson correlation indicated a weak association (Lexicomp: r = 0.475, p = 0.002 and Micromedex: r = 0.491, p = 0.001) and a moderate association (Drugs.com: r = 0.500, p = 0.001) between potential drug-drug interactions and five or more medications.

CONCLUSION

This study showed that the Drugs.com database detected more potential drug interactions between chemotherapy and nonchemotherapy than the Lexicomp and Micromedex databases. Comprehensive drug review, use of electronic health record systems, and collaboration between healthcare providers such as pharmacists and physicians may be necessary strategies to minimize potential drug-drug interactions and optimize cancer treatment in patients with breast cancer.

Oral Problems in Oncology Patients Undergoing Chemotherapy for Solid Tumors: A Prospective Observational Study

PURPOSE

Oral problems in a group of oncological patients undergoing chemotherapy (CT) for solid tumors have been examined. Incidence and severity of patients' self-reported oral problems have been evaluated along their interaction with age, gender, tumor diagnosis and stage, presence of mestastasis, CT agent type, and number of CT cycle. We also analyzed the presence of paraesthesia and anaesthesia and their predisposing factors associated with clinical and treatment-related variables.

METHODS

Patients were asked to fill in a questionnaire to evaluate the onset and the intensity of oral and perioral pain, oral mucositis, salivary gland hypofunction, dysgeusia, dysphagia, dysphonia, and sensitivity neuropathy (paraesthesia or dysaesthesia) since the last CT infusion. We also investigated which types of medications have possibly been used and who recommended it, as well as patients' degree of awareness about the possibility of oral problems arising during CT.

RESULTS

We recruited 194 patients and obtained 491 questionnaires. We found that a metastatic disease was a risk factor for OM (OR 2.02, p = 0.026) and salivary gland hypofunction (OR 1.66, p = 0.042) and that platinum agents, compared to mitotic inhibitors, increased the risk of developing salivary gland hypofunction (OR 2.16, p = 0.013), dysphagia (OR 3.26, p = 0.001), and anaesthesia (OR 5.16, p = 0.041). Young age was a slight protective factor for most symptoms. The 80% of enrolled patients were informed by the oncologist about possible oral problems arising during CT.

CONCLUSIONS

Our study highlighted the importance of collecting observational data from the patients' perspective on oral problems arising during the routine oncology practice, across a range of solid tumors and CT regimens. The relevance of these findings focused on the key role of the multidisciplinary team in advising the patients on the possible occurrence of oral problems, also by recommending their management.

Antitumor effects of polysaccharides from Tetrastigma hemsleyanum Diels et Gilg via regulation of intestinal flora and enhancing immunomodulatory effects in vivo

Tetrastigma hemsleyanum Diels et Gilg is a traditional Chinese herbal medicine with high medicinal value, and antitumor, antioxidant and anti-inflammatory biological activities. However, while several studies have focused on flavonoids in Tetrastigma hemsleyanum tubers, there are few studies on the enhanced immune effect of Tetrastigma hemsleyanum polysaccharides (THP). In this study, we evaluated the antitumor effect of THP in a lung tumor model and explored the mechanism of antitumor activity through intestinal flora. In addition, a cyclophosphamide (CTX)-induced immunosuppression model was used to declare the immunomodulatory effect of THP in the immunosuppressive state induced by antitumor drugs. The results showed that THP increased the content of ileum secreted immunoglobulin A (SIgA) and cecum short-chain fatty acids (SCFAs) and improved microbial community diversity, regulating the relative abundance of dominant microbiota flora from the phylum level to the genus level, and recovering the intestinal microflora disorder caused by tumors. Additionally, THP can increase the organ indices and improve immune organ atrophy. THP can upregulate routine blood counts and stimulate the production of the serum cytokines. THP also promoted the macrophage phagocytic index, NK-cell activation, and complement and immunoglobulin (IgG, IgA, IgM) levels. The detection of Splenic lymphocyte proliferation and T lymphocyte subsets also sideways reflects that THP can restore CTX-induced immune inhibition in mice. In conclusion, this study suggests that THP can effectively achieve the enhanced antitumor effects, regulate gut microbiota and improve the immunosuppression induced by antitumor drugs. Therefore, THP can enhance the immune capacity and provide novel immunomodulatory and antineoplastic adjuvant agents.