Pharmacy, Hôpital Hautepierre, avenue Molière, 67000 Strasbourg, France.
Anticancer Res. 2009 Nov;29(11):4741-4.
The extent of potential pharmacokinetic drug-drug interactions affecting anticancer agents disposition has not been specifically investigated. The prevalence of this type of interaction in adult ambulatory patients receiving systemic chemotherapy in our institution was examined.
The medication list of 200 consecutive cancer patients receiving intravenous chemotherapy was prospectively collected by means of the prescriptions (chemotherapy, supportive care, medications for comorbidities) and a questionnaire (over-the-counter products). Interacting drugs had to have been taken in the previous 7 days. Data concerning the type of cancer and the nature of the comorbidities were also collected. Potential pharmacokinetic drug interactions affecting the activity of the anticancer agent were identified using the guide of drug interactions of the French drug agency (June 2007) and the literature.
A total of 200 patients (mean age 60 years; range 17-96 years) entered the study and 73.5% were female. The most common cancer types were breast cancer (41%), non-Hodgkin's lymphomas (17.5%), and gastrointestinal tumors (12.5%). The majority of the patients (58.5%) had a comorbid illness (cardiovascular diseases, hypothyroidism, diabetes, depression). The median number of medications per patient was 4 (range 1-14). All the patients received systemic chemotherapy but 29 (14.5%) also took anticancer drugs at home. Nine potential pharmacokinetic interactions were found in nine patients (frequency: 4.5%; 95% confidence interval: 1.6-7.4%). Most of the interactions (7/9) involved fluconazole that might alter the metabolism of oxazaphosphorines or the elimination of bortezomib and paclitaxel. One association was contraindicated. Five interactions were not associated with a published clinical effect. No interaction with an enzyme or drug transporter inducer (e.g., rifampin, St. John's wort) was encountered.
The frequence of potential pharmacokinetic interactions affecting the disposition of antitumor drugs was low in this population of ambulatory adult cancer patients and mostly involved the antifungal agent fluconazole.
尚未专门研究影响抗癌药物处置的潜在药代动力学药物-药物相互作用的程度。本研究旨在调查我院接受系统化疗的成年门诊患者中这种类型相互作用的发生率。
通过处方（化疗、支持性护理、合并症药物）和问卷（非处方药）前瞻性收集 200 例连续接受静脉化疗的癌症患者的用药清单。相互作用的药物必须在过去 7 天内服用。还收集了有关癌症类型和合并症性质的数据。使用法国药物机构（2007 年 6 月）和文献中的药物相互作用指南来确定影响抗癌药物活性的潜在药代动力学药物相互作用。
共纳入 200 例患者（平均年龄 60 岁；范围 17-96 岁），其中 73.5%为女性。最常见的癌症类型是乳腺癌（41%）、非霍奇金淋巴瘤（17.5%）和胃肠道肿瘤（12.5%）。大多数患者（58.5%）患有合并症（心血管疾病、甲状腺功能减退症、糖尿病、抑郁症）。每位患者的用药中位数为 4 种（范围 1-14 种）。所有患者均接受系统化疗，但 29 例（14.5%）在家中还服用抗癌药物。在 9 例患者中发现了 9 种潜在的药代动力学相互作用（频率：4.5%；95%置信区间：1.6-7.4%）。大多数相互作用（7/9）涉及氟康唑，可能改变氧化磷酰胺的代谢或硼替佐米和紫杉醇的消除。一种联合用药被禁用。5 种相互作用与已发表的临床效果无关。未发现与酶或药物转运体诱导剂（如利福平、贯叶连翘）的相互作用。
在本门诊成年癌症患者人群中，影响抗肿瘤药物处置的潜在药代动力学相互作用的频率较低，且主要涉及抗真菌药物氟康唑。
