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An onco-informatics database for anticancer drug interactions with complementary and alternative medicines used in cancer treatment and supportive care: an overview of the OncoRx project

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Cancer patients are at high risk of manifesting interactions from use of anticancer drugs (ACDs) and complementary and alternative medicines (CAMs). These interactions can result in sub-therapeutic effects or increased toxicities which may compromise the outcome of chemotherapy. It is important for practitioners to gain convenient access to ACD–CAM interaction information so as to make better-informed decisions in daily practice. This paper describes the creation of an oncology database (OncoRx) that documents ACD–CAM interactions, including traditional Chinese medicines (TCMs) that are commonly used for cancer treatment, prevention, and supportive care therapy.


Information regarding ACDs, CAMs, and drug interactions were collated from 14 sources, inclusive of hardcopy and online resources, and input into a modified web server with a database engine and a programming interface using a combination of software and programming scripts.


OncoRx currently contains a total of 117 ACDs and 166 CAMs. Users are able to search for interactions based on various CAM uses: cancer treatment or prevention, immune-system-related, alopecia, nausea, and vomiting, peripheral neuropathy and pain, inflammation, fatigue, and non-cancer related. Pharmacokinetic data on ACDs and CAMs, characteristics of CAMs based on TCM principles, and drug interaction parameters such as effects, mechanisms, evidences, and proposed management plans, are shown in the search results.


OncoRx is an oncology database which detects ACD interactions. It is currently able to detect interactions with CAMs. It is hoped that OncoRx will serve as a useful resource to clinicians, educators, trainers, and students working in the oncology setting.

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  1. Garcia M, Jemal A, Ward EM, Center MM, Hao Y, Siegel RL, Thun MJ, American Cancer Society (2007) Global cancer facts and figures 2007. Available via Accessed 8 August 2009

  2. Boon HS, Olatunde F, Zick SM (2007) Trends in complementary/alternative medicine use by breast cancer survivors: comparing survey data from 1998 and 2005. BMC Womens Health 7:4. doi:10.1186/1472-6874-7-4

    Article  PubMed  Google Scholar 

  3. Bressler R (2005) Herb–drug interactions: interactions between kava and prescription medications. Geriatrics 60:24–25

    PubMed  Google Scholar 

  4. Tascilar M, de Jong FA, Verweij J, Mathijssen RHJ (2006) Complementary and alternative medicine during cancer treatment: beyond innocence. Oncologist 11:732–741. doi:10.1634/theoncologist.11-7-732

    Article  PubMed  Google Scholar 

  5. Cassileth B, Heitzer M, Gubili J (2008) Integrative oncology: complementary therapies in cancer care. Cancer Chemother Rev 3:204–211

    Google Scholar 

  6. Oldendick R, Coker AL, Wieland D, Raymond JI, Probst JC, Schell BJ, Stoskopf CH (2000) Population-based survey of complementary and alternative medicine usage, patient satisfaction, and physician involvement. South Carolina Complementary Medicine Program Baseline Research Team. South Med J 93:375–381

    CAS  PubMed  Google Scholar 

  7. Yap KY-L, Chui WK, Chan A (2008) Drug interactions between chemotherapeutic regimens and antiepileptics. ClinTher 30:1385–1407. doi:10.1016/j.clinthera.2008.08.011

    CAS  Google Scholar 

  8. Sparreboom A, Cox MC, Acharya MR, Figg WD (2004) Herbal remedies in the United States: potential adverse interactions with anticancer agents. J Clin Oncol 22:2489–2503. doi:10.1200/JCO.2004.08.182

    Article  CAS  PubMed  Google Scholar 

  9. Kuhlmann J, Mück W (2001) Clinical–pharmacological strategies to assess drug interaction potential during drug development. Drug Saf 24:715–725. doi:0114-5916/01/0010-0715

    Article  CAS  PubMed  Google Scholar 

  10. Thomson Healthcare (2007) Micromedex® Healthcare Series [internet database]. Available via Accessed 8 August 2009

  11. Gerstner LV Jr (2008) Memorial Sloan-Kettering Cancer Center—cancer information (about herbs, botanicals and other products). Available via Accessed 8 August 2009

  12. Jellin JM, Gregory PJ (2007) Natural medicines comprehensive database, 10th edn. Therapeutic Research Faculty, Stockton, CA

    Google Scholar 

  13. Chang H-M, But PP-H, Yao S-C, Wang L-L, Yeung SC-S (2001) Pharmacology and applications of Chinese materia medica. World Scientific, Singapore

    Google Scholar 

  14. British Medical Association, Pharmaceutical Society of Great Britain (2007) British national formulary, 53rd edn. BMJ & RPS, London

    Google Scholar 

  15. Lacy CF, Armstrong LL, Goldman MP, Lance LL (2007–2008) Drug information handbook with international trade names index, 15th edn. Lexi-comp, Hudson, OH

    Google Scholar 

  16. Solimando DAJ (2007) Drug information handbook for oncology, 6th edn. Lexi-comp, Hudson, Ohio

    Google Scholar 

  17. e-MS Inc (2004) TCM Assistant. Available via Accessed 8 August 2009

  18. Rootdown LLC (2008)—grow together (v2.187.423.57). Available via Accessed 8 August 2009

  19. Strain JJ, Caliendo G, Himelein C (1998) Using computer databases to predict and avoid drug–drug interactions in the cancer patient requiring psychotropics. Psychooncology 7:321–332

    Article  CAS  PubMed  Google Scholar 

  20. BC Cancer Agency (2007) BCCA cancer drug manual. Available via Accessed 8 August 2009

  21. Klein TE, Chang JT, Cho MK, Easton KL, Fergerson R, Hewett M, Lin Z, Liu Y, Liu S, Oliver DE, Rubin DL, Shafa F, Stuart JM, Altman RB (2001) Integrating genotype and phenotype information: an overview of the PharmGKB project. Pharmacogenomics J 1:167–170

    CAS  PubMed  Google Scholar 

  22. Aetna InteliHealth Inc. Index of herbal medicines and supplements. Available via Accessed 8 August 2009

  23. Thomson Healthcare (2007) Micromedex® Healthcare Series (version 5.1) [intranet database]. Available via Accessed 8 August 2009

  24. Drugsite Trust (2000)™: drug information online. Available via Accessed 8 August 2009

  25. Gold Standard Inc. Caremark Drug Interactions. Available via Accessed 8 August 2009

  26. Enhanced Medical Decisions Inc (2007)™. Available via Accessed 8 August 2009

  27. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT (2000) An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 7:273–282

    CAS  PubMed  Google Scholar 

  28. Sandoval M, Charbonnet RM, Okuhama NN, Roberts J, Krenova Z, Trentacosti AM, Miller MJ (2000) Cat's claw inhibits TNFalpha production and scavenges free radicals: role in cytoprotection. Free Radic Biol Med 29:71–78. doi:10.1016/S0891-5849(00)00327-0

    Article  CAS  PubMed  Google Scholar 

  29. Seeff LB (2007) Herbal hepatotoxicity. Clin Liver Dis 11:577–596. doi:10.1016/j.cld.2007.06.005

    Article  PubMed  Google Scholar 

  30. Ludwig R, Weirich A, Abel U, Hofmann W, Graf N, Tournade M-F (1999) Hepatotoxicity in patients treated according to the Nephroblastoma Trial and Study SIOP-9/GPOH. Med Pediatr Oncol 33:462–469

    Article  CAS  PubMed  Google Scholar 

  31. Marinelli A, de Brauw LM, Beerman H, Keizer HJ, van Bockel JH, Tjaden UR, van de Velde CJH (1996) Isolated liver perfusion with mitomycin C in the treatment of colorectal cancer metastases confined to the liver. Jpn J Clin Oncol 26:341–350

    CAS  PubMed  Google Scholar 

  32. Yarnell E, Abascal K (2007) Interaction of herbal constituents with cytochrome P450 enzymes. Altern Complement Ther 13:239–247. doi:10.1089/act.2007.13508

    Article  Google Scholar 

  33. Unger M, Frank A (2004) Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 18:2273–2281. doi:10.1002/rcm.1621

    Article  CAS  PubMed  Google Scholar 

  34. Gurley BJ, Gardner SF, Hubbard MA, Williams DK, Gentry WB, Cui Y, Ang CY (2002) Cytochrome P450 phenotypic ratios for predicting herb–drug interactions in humans. Clin Pharmacol Ther 72:276–287. doi:10.1067/mcp.2002.126913

    Article  CAS  PubMed  Google Scholar 

  35. Jones BD, Runikis AM (1987) Interaction of ginseng with phenelzine. J Clin Psychopharmacol 7:201–202

    Article  CAS  PubMed  Google Scholar 

  36. Shin HR, Kim JY, Yun TK, Morgan G, Vainio H (2000) The cancer-preventive potential of Panax ginseng: a review of human and experimental evidence. Cancer Causes Control 11:565–576. doi:10.1023/A:1008980200583

    Article  CAS  PubMed  Google Scholar 

  37. Pollock BG, Wylie M, Stack JA, Sorisio DA, Thompson DS, Kirshner MA, Folan MM, Condifer KA (1999) Inhibition of caffeine metabolism by estrogen replacement therapy in postmenopausal women. J Clin Pharmacol 39:936–940

    Article  CAS  PubMed  Google Scholar 

  38. American Society of Health-System Pharmacists (2007) AHFS drug information, 2007th edn. American Society of Health-System Pharmacists, Bethesda, MD

    Google Scholar 

  39. Henderson L, Yue QY, Bergquist C, Gerden B, Arlett P (2002) St John’s wort (Hypericum perforatum): drug interactions and clinical outcomes. Br J Clin Pharmacol 54:349–356. doi:10.1046/j.1365-2125.2002.01683.x

    Article  CAS  Google Scholar 

  40. Komoroski BJ, Zhang S, Cai H, Hutzler JM, Frye R, Tracy TS, Strom SC, Lehmann T, Ang CYW, Cui YY, Venkataramanan R (2004) Induction and inhibition of cytochromes P450 by the St. John’s wort constituent hyperforin in human hepatocyte cultures. Drug Metab Dispos 32:512–518

    Article  CAS  PubMed  Google Scholar 

  41. Markowitz JS, Donovan JL, DeVane CL, Taylor RM, Ruan Y, Wang J-S, Chavin KD (2003) Effect of St John's wort on drug metabolism by induction of cytochrome P450 3A4 enzyme. JAMA 290:1500–1504

    Article  CAS  PubMed  Google Scholar 

  42. Müller WE, Singer A, Wonnemann M, Hafner U, Rolli M, Schäfer C (1998) Hyperforin represents the neurotransmitter reuptake inhibiting constituent of hypericum extract. Pharmacopsychiatry 31:16–21. doi:10.1055/s-2007-979341

    Article  PubMed  Google Scholar 

  43. Mathijssen RHJ, Verweij J, De Bruijn P, De Jonge MJA, Sparreboom A (2002) Modulation of irinotecan (CPT-11) metabolism by St. John’s wort in cancer patients. Proc Am Assoc Cancer Res 43:492 (abstract 2443)

    Google Scholar 

  44. Shader RI, Greenblatt DJ (1988) Bees, ginseng and MAOIs revisited. J Clin Psychopharmacol 8:235

    CAS  PubMed  Google Scholar 

  45. Parekh HS, Liu G, Wei MQ (2009) A new dawn for the use of traditional Chinese medicine in cancer therapy. Mol Cancer 8:21

    Article  PubMed  Google Scholar 

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This article is written within a project financed by the start-up grant awarded by the National University of Singapore. The authors would like to thank the NUS Science Research Programme for their support and contribution to this project.

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Correspondence to Alexandre Chan.

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Yap, K.YL., Kuo, E.Y., Lee, J.J.J. et al. An onco-informatics database for anticancer drug interactions with complementary and alternative medicines used in cancer treatment and supportive care: an overview of the OncoRx project. Support Care Cancer 18, 883–891 (2010).

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