Data for this review were identified by searches in PubMed and references cited in relevant articles. Search items included: “drug interactions”, “drug–drug interactions”, and “oncology”. Only papers published in English were included. Radiopharmaceuticals, hormones, immunotherapeutics used in oncology were considered to be beyond the scope of this report.
ReviewDrug interactions in oncology
Section snippets
Pharmaceutical interactions
Pharmaceutical interactions occur when two compounds interact because of they are incompatible either physically or chemically. An example is when admixtures for infusion are prepared: when the thiol compound mesna is added to a cisplatin solution, it inactivates the platinum drug by forming a covalent mesna–platinum adduct.13 Other examples include the rapid degradation of mitomycin into inactive mitosenes when the drug is dissolved in a 5% dextrose infusion fluid (pH 4–5);14 and the
Pharmacokinetic interactions
Pharmacokinetic interactions arise as a result of the four simple, almost indistinguishable, kinetic principles: absorption, distribution, metabolism, and elimination. Metabolising enzymes or drug transporters are often involved in these processes.
Prediction of drug interactions
Drug interactions can cause many clinical problems. Ideally, all this knowledge is available before a new drug enters clinical testing: although translation of preclinical data to the clinic remains cumbersome and will never be perfect, we should always aim for the maximum attainable therapeutic effect. It is therefore important to continue the collection of more mechanistic and theoretical knowledge about drug interactions. New in vitro and in vivo techniques are also very useful in this
Search strategy and selection criteria
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