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Supportive and palliative care

1957 - Development of an online drug-drug interaction resource to support prescribing of oncolytics

Date

09 Sep 2017

Session

Supportive and palliative care

Topics

Supportive Care and Symptom Management

Presenters

Nienke Lankheet

Citation

Annals of Oncology (2017) 28 (suppl_5): v543-v567. 10.1093/annonc/mdx388

Authors

N.A.G. Lankheet1, F.G. Jansman2, S.E. Gibbons3, D.M. Burger1, K. McAllister3, S.H. Khoo3, N.P. Van Erp1

Author affiliations

  • 1 Department Of Pharmacy, Radboud University Medical Centre Nijmegen, 6525 - Nijmegen/NL
  • 2 Department Of Pharmacy, Deventer Hospital, Deventer/NL
  • 3 Department Of Molecular And Clinical Pharmacology, University of Liverpool, Liverpool/GB
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Resources

Abstract 1957

Background

Patients treated for cancer are at high risk of drug-drug interactions (DDI), which affects nearly 60% of patients on therapy. We developed a freely available DDI resource (www.cancer-druginteractions.org) to support anti-cancer drug prescribing, based on successful implementation for HIV (www.hiv-druginteractions.org) and hepatitis (www.hep-druginteractions.org) treatments.

Methods

A review of literature and registration documents was performed to evaluate the available evidence for potential DDIs of several oncolytics. Decision trees based on the FDA guideline on DDI studies were used to assess clinical relevance of DDIs. Comedications that are frequently used by cancer patients were selected. Interaction potential of drug combinations was classified using a straightforward ‘traffic light’ classification and quality of evidence was classified using the GRADE system. Advice on management of the interaction was included where appropriate. All records were reviewed by an expert panel of clinical pharmacists/pharmacologists.

Results

Thus far, twelve targeted oncolytics for the indications renal cell, hepatocellular and ovarian carcinoma, gastrointestinal stromal tumors, neuroendocrine tumors and sarcoma have been reviewed. Potential DDIs between oncolytics and > 450 comedications have been classified (Table). Tyrosine kinase inhibitors (TKI) show potential interactions which require action of prescribers in more than 20% of reviewed drug combinations. Monoclonal antibodies (MoAB) show clinically relevant DDIs in only 0.7% of reviewed drug combinations.rnTable:

1544PD Overview of evaluated DDIsc

rnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrn
Drug classTKIMoAB
Number of comedications screened for interaction potential (mean)458478
Interaction classification ‘traffic light’ (%)rnrn
Green: No clinically significant interaction64.880.6
Yellow: Interaction of weak/moderate intensity; no a priori dosage adjustment required14.418.7
Amber: Potential interaction which may require dosage adjustment or close monitoring17.50.6
Red: Do not co-administer3.30.1
rn

Conclusions

The DDI checker currently includes comprehensive and ready-to-use advices for DDIs with oncolytics for six indications (these are due to be expanded in the coming months). The freely available, independently developed website with ‘traffic light’ classification will facilitate health care professionals’ and patients’ awareness of potential DDIs between oncolytics and frequently used comedications.

Clinical trial identification

not applicable

Legal entity responsible for the study

Radboud University Medical Center

Funding

Abbvie, Astellas, AstraZeneca, Boehringer Ingelheim, Gilead, Pfizer

Disclosure

K. McAllister, S.H. Khoo: Educational grant from Abbvie and Gilead to perform this project. N.P. Van Erp: Educational grant from Astellas, AstraZeneca, Boehringer Ingelheim, Gilead and Pfizer to perform this project. All other authors have declared no conflicts of interest.

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