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Drug Interactions

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Handbook of Anticancer Pharmacokinetics and Pharmacodynamics

Part of the book series: Cancer Drug Discovery and Development ((CDD&D))

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Abstract

The setting of chemotherapy for cancer is rife with potential for significant drug interactions and this topic has been the subject of several excellent reviews (1–4). Most patients receive multidrug combinations for their malignancy. Also, many of these patients are treated with intercurrent medication for co-morbidity or for cancer-related disorders (coagulopathy, infection, pain, seizures, etc.). The clinical significance of these potential drug interactions is also all the more relevant in cancer chemotherapy because the cytotoxic agents traditionally used do not have clear therapeutic windows. That is, the doses selected produce toxicity in a significant proportion of patients without necessarily providing benefit. Drug interactions causing an increased exposure of the patient to the cytotoxic agent may produce more severe side effects, whereas those causing a decreased exposure may jeopardize tumor control. Unfortunately, both the good and bad effects of chemotherapy are unpredictable, and the influence of drug interactions in either eventuality is almost impossible to detect in individual patients. These, however, may be borne out in large-scale studies, or when combined with pharmacokinetic data (for example, see refs. 5,6). Therefore, most drug interactions in cancer chemotherapy may go undetected unless some a priori knowledge alerts the clinician or oncology pharmacist to their likelihood.

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  1. Laurent P. Rivory
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  1. Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA

    William D. Figg PharmD

  2. Washington University School of Medicine, St. Louis, MO, USA

    Howard L. McLeod PharmD

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Rivory, L.P. (2004). Drug Interactions. In: Figg, W.D., McLeod, H.L. (eds) Handbook of Anticancer Pharmacokinetics and Pharmacodynamics. Cancer Drug Discovery and Development. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-734-5_16

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  • DOI: https://doi.org/10.1007/978-1-59259-734-5_16

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