Potential drug interactions between targeted oral antineoplastic agents and concomitant medication in clinical practice

ABSTRACT

Objectives

Our objective was to analyze potential drug interactions (PDIs) between targeted OAAs and concomitant therapy in clinical practice.

Methods

A cross-sectional observational study was performed in cancer outpatients who started treatment with a targeted OAA between 1 December 2015 and 31 May 2019. PDIs were analyzed using the Lexicomp® and the database About Herbs®. PDIs were classified according to severity, risk, and reliability ratings and their underlying mechanism. Univariate and multivariate analysis were performed to identify risk factors associated with PDIs.

Results

A total of 881 patients were included, of whom 50.9% had at least 1 PDI between the OAA and the concomitant medication. The factors associated with a higher risk of PDIs were polypharmacy (≥5 concomitant medicines) (OR = 3.64 (2.54–5.20), p < 0.001), type of tumor (prostate cancer [OR = not available, p < 0.001], chronic myelogenous leukemia [OR = 5.10 (1.08–24.05), p = 0.040], sarcoma [OR = 4.97 (1.05–23.55), p = 0.043]), and treatment with hormone therapies (OR = not available, p < 0.001).

Conclusion

A search of PDIs should be prioritized, especially in patients receiving targeted OAAs with risk factors, such as polymedication, prostate cancer, chronic myelogenous leukemia, sarcoma, and treatment with hormone therapies.

KEYWORDS:

• Cancer outpatients
• drug interactions
• oral antineoplastic agents
• safety

Author contributions

Vicente Escudero-Vilaplana and Roberto Collado-Borrell were involved in the conception and design of the study. Vicente Escudero-Vilaplana, Roberto Collado-Borrell, Angela Hoyo-Muñoz and Alvaro Gimenez-Manzorro included patients in the study and collected the data. Vicente Escudero-Vilaplana, Antonio Calles, Santiago Osorio, Ana Herranz and María Sanjurjo analyzed and interpreted the results. Vicente Escudero-Vilaplana and Angela Hoyo-Muñoz wrote the first draft. All authors reviewed different drafts and the final version. All authors agree to be accountable for all aspects of the work.

Declaration of interest

V Escudero-Vilaplana reported support to continuing education/advisory fees from Amgen, Astellas, AstraZeneca, Boehringer-Ingelheim, Bristol-Myers Squibb, Ipsen Pharma, Janssen and Merck Sharp & Dohme, outside the submitted work. R Collado-Borrell reported support to continuing education/advisory fees from Boehringer-Ingelheim, Bristol-Myers Squibb, Janssen and Roche, outside the submitted work. A Gimenez-Manzorro reported support to continuing education/advisory fees from Amgen, AstraZeneca, Esai, Gilead and Roche, outside the submitted work. A Calles reported honorary/advisory fees from Roche/Genentech, Eli Lilly and Company, Novartis, Merck Sharp & Dohme, and Bristol-Myers Squibb, outside the submitted work. A Herranz-Alonso reported honorary/advisory fees from Astellas, Janssen, Kern and Novartis, outside the submitted work. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This paper was not funded.