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Interaction between phytotherapy and oral anticancer agents: prospective study and literature review

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Abstract

Cancer is becoming more prevalent in elderly patient. Due to polypharmacy, older adults with cancer are predisposed to drug-drug interactions. There is also an increasing interest in the use of complementary and alternative medicine (CAM). Thirty to seventy percent of patients with cancer have used CAM. Through pharmaceutical counseling sessions, we can provide advices on herb–drug interactions (HDI). All the patients seen in pharmaceutical counseling sessions were prospectively included. Information was collected during these sessions: prescribed medication (oral anticancer agents (OAA) and other drugs), CAM (phytotherapy especially), and use of over-the-counter (OTC) drugs. If pharmacist considered an interaction or an intervention clinically relevant, the oncologist was notified. Then, a literature review was realized to identify the potential HDI (no interactions, precautions for use, contraindication). Among 201 pharmacist counseling sessions, it resulted in 104 interventions related to 46 HDI, 28 drug-drug interactions and 30 others (wrong dosage, omission…). To determine HDI, we review 73 medicinal plants which are used by our patients with cancer and 31 OAA. A total of 1829 recommendations were formulated about 59 (75%) medical plants and their interaction with an OAA. Herb–drug interactions should not be ignored by healthcare providers in their management of cancer patients in daily practice.

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Authors and Affiliations

  1. Department of Pharmacy, University Hospital of Besançon, 25000, Besançon, France

    Anne-Laure Clairet, Marie Boiteux-Jurain, Marie Jeannin, Blandine Gérard, Virginie Nerich & Samuel Limat

  2. Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, 25000, Besançon, France

    Anne-Laure Clairet, Elsa Curtit, Virginie Nerich & Samuel Limat

  3. Department of Medical Oncology, University Hospital of Besançon, 25000, Besançon, France

    Elsa Curtit

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Clairet, AL., Boiteux-Jurain, M., Curtit, E. et al. Interaction between phytotherapy and oral anticancer agents: prospective study and literature review. Med Oncol 36, 45 (2019). https://doi.org/10.1007/s12032-019-1267-z

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