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Potential drug interactions and chemotoxicity in older patients with cancer receiving chemotherapy.

Authors
  • Popa, Mihaela A1
  • Wallace, Kristie J2
  • Brunello, Antonella3
  • Extermann, Martine4
  • Balducci, Lodovico5
  • 1 Biovest International, Inc., Tampa, FL, United States. , (United States)
  • 2 Edward White Hospital, St. Petersburg, FL, United States. , (United States)
  • 3 Istituto Oncologico Veneto-IOV, I.R.C.C.S., Padova, Italy. , (Italy)
  • 4 Senior Adult Oncology Program, Moffitt Cancer Center, Tampa, FL, United States. , (United States)
  • 5 Senior Adult Oncology Program, Moffitt Cancer Center, Tampa, FL, United States. Electronic address: [email protected] , (United States)
Type
Published Article
Journal
Journal of geriatric oncology
Publication Date
Jul 01, 2014
Volume
5
Issue
3
Pages
307–314
Identifiers
DOI: 10.1016/j.jgo.2014.04.002
PMID: 24821377
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Increased risk of drug interactions due to polypharmacy and aging-related changes in physiology among older patients with cancer is further augmented during chemotherapy. No previous studies examined potential drug interactions (PDIs) from polypharmacy and their association with chemotherapy tolerance in older patients with cancer. This study is a retrospective medical chart review of 244 patients aged 70+ years who received chemotherapy for solid or hematological malignancies. PDI among all drugs, supplements, and herbals taken with the first chemotherapy cycle were screened for using the Drug Interaction Facts software, which classifies PDIs into five levels of clinical significance with level 1 being the highest. Descriptive and correlative statistics were used to describe rates of PDI. The association between PDI and severe chemotoxicity was tested with logistic regressions adjusted for baseline covariates. A total of 769 PDIs were identified in 75.4% patients. Of the 82 level 1 PDIs identified among these, 32 PDIs involved chemotherapeutics. A large proportion of the identified PDIs were of minor clinical significance. The risk of severe non-hematological toxicity almost doubled with each level 1 PDI (OR=1.94, 95% CI: 1.22-3.09), and tripled with each level 1 PDI involving chemotherapeutics (OR=3.08, 95% CI: 1.33-7.12). No association between PDI and hematological toxicity was found. In this convenience sample of older patients with cancer receiving chemotherapy we found notable rates of PDI and a substantial adjusted impact of PDI on risk of non-hematological toxicity. These findings warrant further research to optimize chemotherapy outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

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