Abstract 72P
Background
Oral anticancer drugs (OAD) are increasingly integrated into the care of patients (pts) with cancer since last twenty years. Recognition and management of pharmacokinetic/pharmacodynamic drug-drug interactions (DDI) is critical to provide efficacious and safe anticancer and chronic treatments (CT) We aimed to gain insight into the real-world prevalence of potentially significant DDI between OAD and CT and potential consequences on their efficacy and toxicities.
Methods
Prospective observational study in an oncohematological hospital between Oct 2020 – Feb 2022. Pts who started OAD or support treatment (antibiotics, antivirals) for an oncohematological neoplasia were included. Cancer treatment data were obtained from our prescription software System. Demographic data and CT were obtained from our electronic medical record software. Micromedex was used to find potential major/moderate DDI.
Results
In 332 (14.9%) of 2233 treatments started, 548 potential DDI were detected. The mean age was 65.9 (range 19.2-89.5), 170 men and 162 women. The mean interaction/patient was 1.65 (range 1-10), 133 (24.2%) and 415 (75.8%) were classified as major and moderate. The most common cancers were: breast 12%, non-small cell lung carcinoma 12%, renal 10.6% and prostate 7.8% In 10.8% of cases, interactions could lead to lower efficacy of OAD due to metabolism induction or reduced absorption (pazopanib 20.3%, eltrombopag 13.6%, osimertinib 6.8%, isavuconazol 6.8%, cabozantinib/bosutinib/erlotinib 5.1%). In 47.2% higher toxicity could be observed due to metabolism inhibition, competitive inhibition of transporters in the renal tubules or pharmacodynamic interaction (capecitabine 11.2%, sunitnib 9.3%, osimertinib/pazopanib 6.2%, everolimus 5.8%, ibrutinib 5.4%) In 42% efficacy or toxicity of CT could also be affected by OAD such as: imatinib 13.3%, posaconazol 10%, isavuconazol 8.7%, apalutamide 7%, dabrafenib 5.7%, palbociclib 4.8% and osimertinib 4.3%.
Conclusions
DDI between OAD and CT should be checked in cancer patients. Close follow up and monitoring should be considered, if efficacy or toxicities of both treatments can be affected due to multiple or severe DDI.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
E. Fort: Financial Interests, Personal, Invited Speaker: Janssen, AstraZeneca, Ipsen. S. Pernas Simon: Financial Interests, Personal, Advisory Board: Seagen, AstraZeneca, Daiichi Sankyo, Pierre Fabre, Pfizer; Financial Interests, Personal, Invited Speaker: Lilly, Novartis, Eisai, Roche; Financial Interests, Institutional, Invited Speaker: AstraZeneca, Novartis, Daiichi Sankyo; Non-Financial Interests, Personal, Member of Board of Directors: SOLTI. E. Nadal: Financial Interests, Personal, Advisory Board: Roche, Bristol Myers Squibb, Merck Sharp & Dohme, Boehringer Ingelheim, Lilly, Janssen, Pfizer, Merck Serono, Daiichi Sankyo, AstraZeneca, Takeda, Amgen, Sanofi, Qiagen, Janssen; Financial Interests, Personal, Invited Speaker: Roche, Bristol Myers Squibb, Merck Sharp Dohme, Boehringer Ingelheim, Lilly, Pfizer, Sanofi, AstraZeneca, Takeda, Amgen, Qiagen, Janssen; Financial Interests, Personal and Institutional, Funding, Clinical trial funded by Roche: Roche; Financial Interests, Personal and Institutional, Funding, BMS funded a clinical trial: Bristol Myers Squibb; Financial Interests, Personal and Institutional, Funding, Merck Serono funded a clinical trial: Merck Serono; Non-Financial Interests, Personal, Advisory Role: Pfizer, Roche. R. Palmero Sanchez: Financial Interests, Personal, Advisory Board: AstraZeneca, Boehringer Ingelheim, AstraZeneca; Financial Interests, Personal, Invited Speaker: Guardant Health, Pfizer. J.M. Piulats: Financial Interests, Personal, Advisory Board: Janssen, Astellas, Roche, BMS, MSD, BeiGene, VCN, AstraZeneca; Financial Interests, Personal and Institutional, Research Grant: BMS, Pfizer, Janssen, BeiGene, Mirati. A.C. Oliveira: Financial Interests, Personal, Invited Speaker: Janssen, AbbVie, AstraZeneca, BeiGene. All other authors have declared no conflicts of interest.