Potential drug interactions and chemotoxicity in older patients with cancer receiving chemotherapy

Mihaela A. Popa, Kristie J. Wallace, Antonella Brunello, Martine Extermann, Lodovico Balducci

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Purpose: Increased risk of drug interactions due to polypharmacy and aging-related changes in physiology among older patients with cancer is further augmented during chemotherapy. No previous studies examined potential drug interactions (PDIs) from polypharmacy and their association with chemotherapy tolerance in older patients with cancer. Methods: This study is a retrospective medical chart review of 244 patients aged 70. + years who received chemotherapy for solid or hematological malignancies. PDI among all drugs, supplements, and herbals taken with the first chemotherapy cycle were screened for using the Drug Interaction Facts software, which classifies PDIs into five levels of clinical significance with level 1 being the highest. Descriptive and correlative statistics were used to describe rates of PDI. The association between PDI and severe chemotoxicity was tested with logistic regressions adjusted for baseline covariates. Results: A total of 769 PDIs were identified in 75.4% patients. Of the 82 level 1 PDIs identified among these, 32 PDIs involved chemotherapeutics. A large proportion of the identified PDIs were of minor clinical significance. The risk of severe non-hematological toxicity almost doubled with each level 1 PDI (OR. = 1.94, 95% CI: 1.22-3.09), and tripled with each level 1 PDI involving chemotherapeutics (OR. = 3.08, 95% CI: 1.33-7.12). No association between PDI and hematological toxicity was found. Conclusions: In this convenience sample of older patients with cancer receiving chemotherapy we found notable rates of PDI and a substantial adjusted impact of PDI on risk of non-hematological toxicity. These findings warrant further research to optimize chemotherapy outcomes.

Original languageEnglish
Pages (from-to)307-314
Number of pages8
JournalJournal of Geriatric Oncology
Volume5
Issue number3
DOIs
Publication statusPublished - 2014

Fingerprint

Drug Interactions
Drug Therapy
Neoplasms
Polypharmacy
Hematologic Neoplasms

Keywords

  • Chemotherapy
  • Chemotoxicity
  • CTCAE
  • Drug Interaction Facts™
  • Drug interaction software
  • Drug interactions
  • Elderly
  • Geriatric oncology

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Oncology
  • Medicine(all)

Cite this

Potential drug interactions and chemotoxicity in older patients with cancer receiving chemotherapy. / Popa, Mihaela A.; Wallace, Kristie J.; Brunello, Antonella; Extermann, Martine; Balducci, Lodovico.

In: Journal of Geriatric Oncology, Vol. 5, No. 3, 2014, p. 307-314.

Research output: Contribution to journalArticle

Popa, Mihaela A. ; Wallace, Kristie J. ; Brunello, Antonella ; Extermann, Martine ; Balducci, Lodovico. / Potential drug interactions and chemotoxicity in older patients with cancer receiving chemotherapy. In: Journal of Geriatric Oncology. 2014 ; Vol. 5, No. 3. pp. 307-314.
@article{ba0487c073064b8f810314023822c1e2,
title = "Potential drug interactions and chemotoxicity in older patients with cancer receiving chemotherapy",
abstract = "Purpose: Increased risk of drug interactions due to polypharmacy and aging-related changes in physiology among older patients with cancer is further augmented during chemotherapy. No previous studies examined potential drug interactions (PDIs) from polypharmacy and their association with chemotherapy tolerance in older patients with cancer. Methods: This study is a retrospective medical chart review of 244 patients aged 70. + years who received chemotherapy for solid or hematological malignancies. PDI among all drugs, supplements, and herbals taken with the first chemotherapy cycle were screened for using the Drug Interaction Facts software, which classifies PDIs into five levels of clinical significance with level 1 being the highest. Descriptive and correlative statistics were used to describe rates of PDI. The association between PDI and severe chemotoxicity was tested with logistic regressions adjusted for baseline covariates. Results: A total of 769 PDIs were identified in 75.4{\%} patients. Of the 82 level 1 PDIs identified among these, 32 PDIs involved chemotherapeutics. A large proportion of the identified PDIs were of minor clinical significance. The risk of severe non-hematological toxicity almost doubled with each level 1 PDI (OR. = 1.94, 95{\%} CI: 1.22-3.09), and tripled with each level 1 PDI involving chemotherapeutics (OR. = 3.08, 95{\%} CI: 1.33-7.12). No association between PDI and hematological toxicity was found. Conclusions: In this convenience sample of older patients with cancer receiving chemotherapy we found notable rates of PDI and a substantial adjusted impact of PDI on risk of non-hematological toxicity. These findings warrant further research to optimize chemotherapy outcomes.",
keywords = "Chemotherapy, Chemotoxicity, CTCAE, Drug Interaction Facts™, Drug interaction software, Drug interactions, Elderly, Geriatric oncology",
author = "Popa, {Mihaela A.} and Wallace, {Kristie J.} and Antonella Brunello and Martine Extermann and Lodovico Balducci",
year = "2014",
doi = "10.1016/j.jgo.2014.04.002",
language = "English",
volume = "5",
pages = "307--314",
journal = "Journal of Geriatric Oncology",
issn = "1879-4068",
publisher = "Elsevier Limited",
number = "3",

}

TY - JOUR

T1 - Potential drug interactions and chemotoxicity in older patients with cancer receiving chemotherapy

AU - Popa, Mihaela A.

AU - Wallace, Kristie J.

AU - Brunello, Antonella

AU - Extermann, Martine

AU - Balducci, Lodovico

PY - 2014

Y1 - 2014

N2 - Purpose: Increased risk of drug interactions due to polypharmacy and aging-related changes in physiology among older patients with cancer is further augmented during chemotherapy. No previous studies examined potential drug interactions (PDIs) from polypharmacy and their association with chemotherapy tolerance in older patients with cancer. Methods: This study is a retrospective medical chart review of 244 patients aged 70. + years who received chemotherapy for solid or hematological malignancies. PDI among all drugs, supplements, and herbals taken with the first chemotherapy cycle were screened for using the Drug Interaction Facts software, which classifies PDIs into five levels of clinical significance with level 1 being the highest. Descriptive and correlative statistics were used to describe rates of PDI. The association between PDI and severe chemotoxicity was tested with logistic regressions adjusted for baseline covariates. Results: A total of 769 PDIs were identified in 75.4% patients. Of the 82 level 1 PDIs identified among these, 32 PDIs involved chemotherapeutics. A large proportion of the identified PDIs were of minor clinical significance. The risk of severe non-hematological toxicity almost doubled with each level 1 PDI (OR. = 1.94, 95% CI: 1.22-3.09), and tripled with each level 1 PDI involving chemotherapeutics (OR. = 3.08, 95% CI: 1.33-7.12). No association between PDI and hematological toxicity was found. Conclusions: In this convenience sample of older patients with cancer receiving chemotherapy we found notable rates of PDI and a substantial adjusted impact of PDI on risk of non-hematological toxicity. These findings warrant further research to optimize chemotherapy outcomes.

AB - Purpose: Increased risk of drug interactions due to polypharmacy and aging-related changes in physiology among older patients with cancer is further augmented during chemotherapy. No previous studies examined potential drug interactions (PDIs) from polypharmacy and their association with chemotherapy tolerance in older patients with cancer. Methods: This study is a retrospective medical chart review of 244 patients aged 70. + years who received chemotherapy for solid or hematological malignancies. PDI among all drugs, supplements, and herbals taken with the first chemotherapy cycle were screened for using the Drug Interaction Facts software, which classifies PDIs into five levels of clinical significance with level 1 being the highest. Descriptive and correlative statistics were used to describe rates of PDI. The association between PDI and severe chemotoxicity was tested with logistic regressions adjusted for baseline covariates. Results: A total of 769 PDIs were identified in 75.4% patients. Of the 82 level 1 PDIs identified among these, 32 PDIs involved chemotherapeutics. A large proportion of the identified PDIs were of minor clinical significance. The risk of severe non-hematological toxicity almost doubled with each level 1 PDI (OR. = 1.94, 95% CI: 1.22-3.09), and tripled with each level 1 PDI involving chemotherapeutics (OR. = 3.08, 95% CI: 1.33-7.12). No association between PDI and hematological toxicity was found. Conclusions: In this convenience sample of older patients with cancer receiving chemotherapy we found notable rates of PDI and a substantial adjusted impact of PDI on risk of non-hematological toxicity. These findings warrant further research to optimize chemotherapy outcomes.

KW - Chemotherapy

KW - Chemotoxicity

KW - CTCAE

KW - Drug Interaction Facts™

KW - Drug interaction software

KW - Drug interactions

KW - Elderly

KW - Geriatric oncology

UR - http://www.scopus.com/inward/record.url?scp=84904964958&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84904964958&partnerID=8YFLogxK

U2 - 10.1016/j.jgo.2014.04.002

DO - 10.1016/j.jgo.2014.04.002

M3 - Article

C2 - 24821377

AN - SCOPUS:84904964958

VL - 5

SP - 307

EP - 314

JO - Journal of Geriatric Oncology

JF - Journal of Geriatric Oncology

SN - 1879-4068

IS - 3

ER -