Abstract
Cytochrome P450 interacting medication use in adult advanced solid tumor and phase I trial patients
Journal of clinical oncology, Vol.32(15_suppl), pp.2591-2591
05/20/2014
DOI: 10.1200/jco.2014.32.15_suppl.2591
Abstract
Abstract only
Background: Cancer patients often take multiple medications increasing the potential for drug-drug interactions. There is limited data regarding the frequency of cytochrome P450 (CYP) medication use in advanced cancer patients or among subjects enrolling in phase I trials. The objective of this study was to characterize medication use in adult advanced solid tumor patients, including those in phase I trials. Methods: We evaluated the electronic health record for medication use in adult patients with advanced solid tumors seen at the University of Wisconsin from 1/2008-7/2011. Two cohorts (metastatic and phase I) were established. Demographics, co-morbidities, and medications were abstracted. Each medication’s CYP-interaction was classified using Lexicomp. We also reviewed charts from NCI-sponsored phase I trials from 1/2007- 12/2009 involving CYP interacting drugs. The CYP pathway affected, concurrent and contraindicated medications, and changes in medications for study eligibility were recorded. Results: Data from 1,773 patients were analyzed: 1,489 in the metastatic cohort [median age 62 (18-93), 52% female] and 284 in the phase I cohort [median age 59 (18-80), 57% female]. Polypharmacy was seen in both groups (95% phase I vs. 80% metastatic; p<0.001). The majority of the metastatic cohort were taking CYP interacting medications (87% ≥ 1 inhibitor, 45% ≥ 1 inducer and 79% ≥ 1 sensitive substrate). Use of moderate-strong inducers or inhibitors was also common: ≥ 1 inducer (40% and 36%) and ≥ 1 inhibitor (61% and 66%), metastatic and phase I, respectively. Separately, 4 phase I trials were evaluated, involving 294 screened subjects – 3.8% screen failed due to interacting medications. Charts from 74 enrolled subjects revealed 655 concurrent medications (average 8.9/subject). 93 medications were CYP-interacting and 51(69%) subjects were on ≥1 interacting medication. Of the 93 medications: 38 (41%) were stopped and 41 (44%) were changed for study. Conclusions: CYP-interacting medication use is common in patients with advanced cancer. Medications are frequently discontinued or changed for enrollment in phase I trials. This has important implications for translating phase I results into practice.
Details
- Title: Subtitle
- Cytochrome P450 interacting medication use in adult advanced solid tumor and phase I trial patients
- Creators
- Kari Braun Wisinski - University of Wisconsin Carbone Cancer CenterColby Austin Cantu - University of Wisconsin–MadisonJens C. Eickhoff - University of Wisconsin–MadisonKurt Osterby - University of Wisconsin–MadisonAmye Tevaarwerk - University of Wisconsin Carbone Cancer CenterGlenn Liu - University of Wisconsin Carbone Cancer CenterGeorge Wilding - University of Wisconsin Carbone Cancer CenterSusan Johnston - University of Wisconsin–MadisonJill Kolesar - University of Wisconsin Carbone Cancer Center
- Resource Type
- Abstract
- Publication Details
- Journal of clinical oncology, Vol.32(15_suppl), pp.2591-2591
- DOI
- 10.1200/jco.2014.32.15_suppl.2591
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Language
- English
- Date published
- 05/20/2014
- Academic Unit
- Pharmacy; Pharmaceutical Sciences and Experimental Therapeutics
- Record Identifier
- 9984695784502771
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