학술논문

Complexity and clinical significance of drug-drug interactions (DDIs) in oncology: challenging issues in the care of patients regarding cancer-associated thrombosis (CAT)
Document Type
Academic Journal
Source
Supportive Care in Cancer. October, 2022, Vol. 30 Issue 10, p8559, 15 p.
Subject
Cancer patients -- Drug therapy
Blood clot -- Drug therapy -- Complications and side effects -- Development and progression
Anticoagulants (Medicine) -- Complications and side effects
Thrombosis -- Drug therapy -- Complications and side effects -- Development and progression
Drug interactions
Cytochrome P-450
Language
English
ISSN
0941-4355
Abstract
Cancer patients have an increased risk of developing venous thromboembolic events. Anticoagulation management includes prophylactic or therapeutic doses of low molecular weight heparins (LMWHs) or direct oral anticoagulants (DOACs). However, the management of thrombosis in patients with cancer is complex due to various individual and disease-related factors, including drug-drug interactions (DDIs). Furthermore, DDIs may impact both, cancer and venous thrombosis, treatment effectiveness and safety; their relevance is highlighted by the advances in cancer therapeutics. Given that these new oncology drugs are extensively used, more attention should be given to monitoring potential DDIs to minimize risks. Recognition of DDIs is of utmost importance in an era of rapid developments in cancer treatments and introduction of novel treatments and protocols. When managing cancer-associated thrombosis (CAT), the concomitant use of a DOAC and a moderate or strong modulator (inhibitor or inducer) of CYP3A4 or a P-glycoprotein (P-gp) is most likely to be associated with significant DDIs. Therefore, LMWHs remain the first-line option for the long-term management of CAT under these circumstances and physicians must consider utilizing LMWHs as first line. This review describes the risk of DDIs and their potential impact and outcomes in patients with cancer associated thrombosis (CAT) receiving anticoagulation.
Author(s): Nikolaos Tsoukalas [sup.1] [sup.2], Norman Brito-Dellan [sup.3], Carme Font [sup.4], Taylor Butler [sup.5], Cristhiam M. Rojas-Hernandez [sup.6], Thomas Butler [sup.7], Carmen Escalante [sup.8] Author Affiliations: (1) grid.413158.a, 0000 0004 [...]