Yale School of Public Health, Yale University, New Haven, CT 06510, USA.
Yale Cancer Center, New Haven, CT 06510, USA.
Nutrients. 2021 Oct 22;13(11):3730. doi: 10.3390/nu13113730.
The use of dietary supplements is common in the general population and even more prevalent among cancer survivors. The World Cancer Research Fund/American Institute for Cancer Research specifies that dietary supplements should not be used for cancer prevention. Several dietary supplements have potential pharmacokinetic and pharmacodynamic interactions that may change their clinical efficacy or potentiate adverse effects of the adjuvant endocrine therapy prescribed for breast cancer treatment. This analysis examined the prevalence of self-reported dietary supplement use and the potential interactions with tamoxifen and aromatase inhibitors (AIs) among breast cancer survivors enrolled in three randomized controlled trials of lifestyle interventions conducted between 2010 and 2017. The potential interactions with tamoxifen and AIs were identified using the Natural Medicine Database. Among 475 breast cancer survivors (2.9 (mean) or 2.5 (standard deviation) years from diagnosis), 393 (83%) reported using dietary supplements. A total of 108 different types of dietary supplements were reported and 36 potential adverse interactions with tamoxifen or AIs were identified. Among the 353 women taking tamoxifen or AIs, 38% were taking dietary supplements with a potential risk of interactions. We observed a high prevalence of dietary supplement use among breast cancer survivors and the potential for adverse interactions between the prescribed endocrine therapy and dietary supplements was common.
膳食补充剂的使用在普通人群中很常见，在癌症幸存者中更为普遍。世界癌症研究基金会/美国癌症研究所规定，膳食补充剂不应用于癌症预防。一些膳食补充剂可能具有潜在的药代动力学和药效学相互作用，这可能会改变它们的临床疗效或增强辅助内分泌治疗的不良反应，而这些治疗是为乳腺癌治疗开的。本分析检查了在 2010 年至 2017 年期间进行的三项生活方式干预随机对照试验中招募的乳腺癌幸存者中自我报告的膳食补充剂使用情况以及与他莫昔芬和芳香化酶抑制剂（AIs）的潜在相互作用的流行率。使用天然药物数据库来识别与他莫昔芬和 AIs 的潜在相互作用。在 475 名乳腺癌幸存者（诊断后 2.9（平均值）或 2.5（标准差）年）中，有 393 名（83%）报告使用了膳食补充剂。报告了 108 种不同类型的膳食补充剂，并确定了 36 种与他莫昔芬或 AIs 有潜在不良相互作用的膳食补充剂。在 353 名服用他莫昔芬或 AIs 的女性中，有 38%服用的膳食补充剂有潜在的相互作用风险。我们观察到乳腺癌幸存者中膳食补充剂使用的高流行率，以及规定的内分泌治疗与膳食补充剂之间发生不良反应相互作用的可能性很高。
