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Concomitant polypharmacy is associated with irinotecan-related adverse drug reactions in patients with cancer

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Abstract

Background

Patients with cancer often receive chemotherapeutic agents concurrently with other medications to treat comorbidity. The practical effects of concomitant medications, especially polypharmacy, on adverse drug reactions related to irinotecan-based chemotherapy are not well documented.

Methods

Associations of adverse drug reactions related to irinotecan monotherapy or a combination of irinotecan, 5-fluorouracil, and l-leucovorin (FOLFIRI) with concomitant medicines used to treat comorbidity were retrospectively investigated in Japanese patients with cancer.

Results

Of the 172 patients, 118 received concomitant medications. Twenty-one patients had grade 4 neutropenia and/or grade 3 or 4 diarrhea. Univariate and multivariate analyses revealed that concomitant medications were significantly associated with irinotecan-related severe neutropenia and/or diarrhea (P = 0.023 and 0.044). Multiple concomitant medications were significantly related to severe irinotecan-related toxicity in patients given monotherapy or FOLFIRI (P = 0.01). The incidence of severe irinotecan-related toxicities increased in parallel with the number of concomitant medications.

Conclusion

We found that multiple concomitant medicines were significantly associated with severe irinotecan-related toxicity, indicating that polypharmacy must be effectively managed to decrease the risk of adverse drug reactions in patients with cancer who received irinotecan-based chemotherapy.

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Acknowledgments

This work was supported in part by a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (21S-8-1 to Y.S.), in part by a Grant-in-Aid for Scientific Research (C) (23590198 to K.F.) from the Japan Society for the Promotion of Science (JSPS), and in part by a Grant-in-Aid for “Support Project of Strategic Research Center in Private Universities” from the Ministry of Education, Culture, Sports, Science and Technology (MEXT) to Saitama Medical University Research Center for Genomic Medicine.

Conflict of interest

All authors have no conflict of interests.

Author information

Author notes

  1. Hiroo Ishida

    Present address: Division of Respiratory Medicine and Allergology, Department of Internal Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan

  2. Shigehira Saji

    Present address: Department of Target Therapy Oncology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo, Kyoto, 606-8507, Japan

Authors and Affiliations

  1. Department of Clinical Research Support Center, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan

    Tetsuya Sasaki

  2. Department of Medical Oncology, International Medical Center-Comprehensive Cancer Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan

    Ken-ichi Fujita, Yu Sunakawa, Hiroo Ishida, Keishi Yamashita, Keisuke Miwa, Shigehira Saji & Yasutsuna Sasaki

  3. Project Research Laboratory, Research Center for Genomic Medicine, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, 350-1241, Japan

    Ken-ichi Fujita & Yasutsuna Sasaki

  4. Department of Drug Information, Showa University School of Pharmaceutical Sciences, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8555, Japan

    Tetsuya Sasaki & Yasuhisa Kato

Authors
  1. Tetsuya Sasaki
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  2. Ken-ichi Fujita
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  3. Yu Sunakawa
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  4. Hiroo Ishida
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  5. Keishi Yamashita
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  6. Keisuke Miwa
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  7. Shigehira Saji
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  8. Yasuhisa Kato
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  9. Yasutsuna Sasaki
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Corresponding author

Correspondence to Ken-ichi Fujita.

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Sasaki, T., Fujita, Ki., Sunakawa, Y. et al. Concomitant polypharmacy is associated with irinotecan-related adverse drug reactions in patients with cancer. Int J Clin Oncol 18, 735–742 (2013). https://doi.org/10.1007/s10147-012-0425-5

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  • DOI: https://doi.org/10.1007/s10147-012-0425-5

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