Email this article Evaluation of drug-drug interactions in patients receiving FOLFOX chemotherapy: A prospective study
- Authors: Fedorinov D.S.1,2,3, Lyadova M.A.4,5, Lyadov V.K.3,4,5, Sychev D.A.1,3
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Affiliations:
- Petrovsky National Research Center of Surgery
- Moscow Multidisciplinary Clinical Center "Kommunarka"
- Russian Medical Academy of Continuous Professional Education
- Moscow State Budgetary Healthcare Institution «Moscow City Hospital named after S.S. Yudin, Moscow Healthcare Department»
- Novokuznetsk State Institute for Further Training of Physicians Branch Campus of the Russian Medical Academy of Continuous Professional Education
- Issue: Vol 27, No 3 (2025)
- Pages: 162-167
- Section: Articles
- URL: https://journal-vniispk.ru/1815-1434/article/view/363015
- DOI: https://doi.org/10.26442/18151434.2025.3.203314
- ID: 363015
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Abstract
Aim. To evaluate the frequency and clinical significance of drug-drug interactions (DDI) in patients receiving drug antitumor therapy using the Drugs® and Medscape® DDI calculators.
Materials and methods. The study included 282 patients with a mean age of 65 years (36–84) who received FOLFOX chemotherapy, of whom 151 (53%) were males and 131 (47%) were females. At the start of the first course of chemotherapy, 214 (75%) patients were receiving concomitant therapy on a regular basis.
Results. The odds of severe toxicity in patients receiving concomitant therapy were 2.720 times higher [95% confidence interval (CI) 1.025–7.218; p=0.038]. Patients with strong DDI were statistically significantly more likely to develop mucositis after the first course of drug antitumor therapy: 14 (38.9%) vs 36 (20.2%) according to Drugs®, p=0.041; 22 (33.3%) vs 28 (18.9%) according to Medscape®; p=0.036. Similar results were obtained in a subgroup of patients at risk of QT prolongation according to Drugs® – 10 (52.6%) vs 40 (20.5%); p<0.001. Patients taking calcium channel blockers were statistically significantly more likely to develop dose-limiting toxicity: 18 (40.9%) vs 52 (21.8%). The odds of dose-limiting toxicity were 2.476 times higher: 95% CI 1.261–4.864; p=0.007.
Conclusion. The incidence of DDI in patients with gastrointestinal tumors receiving FOLFOX best supportive therapy can be as high as 90.2%, with one in three DDI classified as serious. Drugs® and Medscape® DDI services cover only 80% of concomitant medications and are not adapted to oncology, necessitating the development of more versatile approaches.
Keywords
About the authors
Denis S. Fedorinov
Petrovsky National Research Center of Surgery; Moscow Multidisciplinary Clinical Center "Kommunarka"; Russian Medical Academy of Continuous Professional Education
Author for correspondence.
Email: deni_fe@mail.ru
ORCID iD: 0000-0001-5516-7367
SPIN-code: 1079-8460
Oncologist
Russian Federation, Moscow; Moscow; MoscowMarina A. Lyadova
Moscow State Budgetary Healthcare Institution «Moscow City Hospital named after S.S. Yudin, Moscow Healthcare Department»; Novokuznetsk State Institute for Further Training of Physicians Branch Campus of the Russian Medical Academy of Continuous Professional Education
Email: deni_fe@mail.ru
ORCID iD: 0000-0002-9558-5579
SPIN-code: 8220-2854
Cand. Sci. (Med.)
Russian Federation, Moscow; NovokuznetskVladimir K. Lyadov
Russian Medical Academy of Continuous Professional Education; Moscow State Budgetary Healthcare Institution «Moscow City Hospital named after S.S. Yudin, Moscow Healthcare Department»; Novokuznetsk State Institute for Further Training of Physicians Branch Campus of the Russian Medical Academy of Continuous Professional Education
Email: deni_fe@mail.ru
ORCID iD: 0000-0002-7281-3591
SPIN-code: 5385-7889
D. Sci. (Med.)
Russian Federation, Moscow; Moscow; NovokuznetskDmitry A. Sychev
Petrovsky National Research Center of Surgery; Russian Medical Academy of Continuous Professional Education
Email: deni_fe@mail.ru
ORCID iD: 0000-0002-4496-3680
SPIN-code: 4525-7556
D. Sci. (Med.), Prof., Acad. RAS
Russian Federation, Moscow; MoscowReferences
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