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Clinical and Translational Oncology

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24.05.2020 | Research Article

Breast cancer, placing drug interactions in the spotlight: is polypharmacy the cause of everything?

verfasst von: José Alberto Domínguez-Alonso, David Conde-Estévez, David Bosch, Maria Pi-Figueras, Ignacio Tusquets

Erschienen in: Clinical and Translational Oncology | Ausgabe 1/2021

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Abstract

Purpose

Breast cancer is the most prevalent and lethal cancer among women. Forty-one percent of cases occur in people ≥ 70 years, hindering their treatment given its comorbidities and polypharmacy (PP). Potential drug–drug interactions (PDDI) were analyzed in elderly breast cancer patients between daily and oncospecific treatments and their associations with Age, BMI, Mini Nutritional Assessment (MNA), Frailty categorization, PP, and adverse effects.

Patients/methods

A cohort of 77 patients ≥ 70 years with breast cancer who underwent a Comprehensive Geriatric Assessment (CGA) were included. Clinical characteristics were collected using medical records. PDDI between treatments were analyzed using two databases. Data were assessed using linear regression, Chi-square, Mann–Whitney U, and Kruskal–Wallis tests. Finally, a multivariate logistic regression model was built and tested to predict adverse effects.

Results

From 719 PDDI, 530 (74%) were moderate (r² = 0.72) and the median number of drugs during oncospecific treatment (r² = 0.73) was 9 (range 3–26). Overall, 59 patients (77%) had adverse effects associated with Frailty categorization and MNA (p < 0.05). The distribution of major, moderate, minor, and total PDDI was associated with PP at CGA and during oncospecific treatment (p < 0.05). Moreover, it was verified that Frailty categorization protects from adverse effects given the intervention made at CGA.

Conclusions

CGA should be applied in oncologic elderly patients to assess clinical outcomes and categorize them according to their frailty but also to analyze PDDI. Furthermore, we encourage the use of the model in clinical practice for predicting the occurrence of adverse effects, improving therapeutic conciliation.

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Titel: Breast cancer, placing drug interactions in the spotlight: is polypharmacy the cause of everything?
verfasst von: José Alberto Domínguez-Alonso
David Conde-Estévez
David Bosch
Maria Pi-Figueras
Ignacio Tusquets
Publikationsdatum: 24.05.2020
Verlag: Springer International Publishing
Erschienen in: Clinical and Translational Oncology / Ausgabe 1/2021
Print ISSN: 1699-048X
Elektronische ISSN: 1699-3055
DOI: https://doi.org/10.1007/s12094-020-02386-8

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Breast cancer, placing drug interactions in the spotlight: is polypharmacy the cause of everything?