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An exploration of the impact of ethanol diluent on breath alcohol concentration in patients receiving paclitaxel chemotherapy

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Abstract

Purpose

This study aimed to provide a better understanding of the impact of paclitaxel chemotherapy on breath alcohol in an Irish population.

Methods

Patients attending the Oncology Day Unit at Beaumont Hospital were invited to participate on the day of their treatment. The brand of paclitaxel used was Actavis Pharma Inc and contained 6 mg/mL paclitaxel in 50% Ethanol/ 50% Cremophor EL. Breath alcohol concentration was measured using the AlcoSense ™ Breathalyser on three separate visits. The primary end-point was the number of patients who were above the legal threshold for drink driving in Ireland.

Results

In total, 50 patients were recruited. 36 (68%) were female. The most common diagnosis was breast cancer (56%). Ten (20%) patients had metastatic disease and 4 (8%) had liver metastases. The mean paclitaxel dose administered was 118 mg. The mean amount of ethanol infused was 7.7 g. 27 patients had a detectable breath alcohol level on at least one visit. The mean breath alcohol concentration was 2 mcg/100 mL or 0.02 mg/L of breath. The maximum concentration of ethanol in exhaled breath was 11 mcg/100 mL or 0.11 mg/L which is 50% of the statutory limit for drink driving in Ireland. A weak correlation was observed between ethanol concentration in exhaled breath and the total amount of ethanol administered. Although no patient exceeded the general limit for drink driving in Ireland, three (6%) participants had a breath alcohol concentration above the threshold for professional, learner or novice drivers.

Conclusion

Although definitive conclusions are limited by relatively small numbers, it seems unlikely that weekly paclitaxel infusions pose any significant risk to patients driving.

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Data availability

The data that support the findings of this study are available from the corresponding author on request.

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Medical Oncology, Beaumont Hospital, Dublin 9, Ireland

    R. J. Keogh, M. A. Hennessy, Z. Coyne, D. Cowzer, B. T. Hennessy, L. Grogan, P. G. Morris & O. S. Breathnach

  2. Cancer Clinical Trials and Research Unit, Beaumont Hospital, Dublin 9, Ireland

    M. Milewski, K. Browne, K. Egan, B. T. Hennessy, L. Grogan, P. G. Morris & O. S. Breathnach

  3. Royal College of Surgeons Ireland, Dublin, Ireland

    B. T. Hennessy, P. G. Morris & O. S. Breathnach

Authors
  1. R. J. Keogh
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  2. M. Milewski
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  3. K. Browne
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  4. K. Egan
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  5. M. A. Hennessy
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  6. Z. Coyne
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  7. D. Cowzer
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  8. A. Linehan
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  9. B. T. Hennessy
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  10. L. Grogan
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  11. P. G. Morris
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  12. O. S. Breathnach
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by RJK, MM, KB, KE, LG, PGM, OSB. The first draft was written by RK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to R. J. Keogh.

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Conflict of interest

Travel support: Patrick G. Morris, Roche, Novartis, Amgen; Honoraria: Patrick G. Morris, Astellas, Novartis, Pfizer, Teva, Nordic 2013, Bristol Meyers Squibb, Astra Zeneca, Genomic health, Roche; Consultancy or Advisory role: Patrick G. Morris, Novartis, Speaker Role: Patrick G. Morris, Teva; Research funding: Patrick G. Morris, Teva, Genomic Health.

Ethical approval

This study was approved by the Beaumont Hospital Institutional Review Board prior to study initiation. This study was performed in accordance with the Internal Conference on Harmonisation (ICH) for Good Clinical Practice (GCP) and the ethical principles founded in the Declaration of Helsinki.

Informed consent

All patients gave written informed consent to participate in the study.

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Keogh, R.J., Milewski, M., Browne, K. et al. An exploration of the impact of ethanol diluent on breath alcohol concentration in patients receiving paclitaxel chemotherapy. Cancer Chemother Pharmacol 88, 307–312 (2021). https://doi.org/10.1007/s00280-021-04279-1

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  • DOI: https://doi.org/10.1007/s00280-021-04279-1

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