Harnessing drug/radiation interaction through daily routine practice: Leverage medical and methodological point of view (MORSE 02-17 study)

Radiother Oncol. 2018 Dec;129(3):471-478. doi: 10.1016/j.radonc.2018.06.010. Epub 2018 Jun 21.

Abstract

Background: Safety profile of the interaction between anticancer drugs and radiation is a recurrent question. However, there are little data regarding the non-anticancer treatment (NACT)/radiation combinations. The aim of the present study was to investigate concomitant NACTs in patients undergoing radiotherapy in a French comprehensive cancer center.

Methods: A prospective cross-sectional study was conducted. All cancer patients undergoing a palliative or curative radiotherapy were consecutively screened for six weeks in 2016. Data on NACTs were collected.

Results: Out of 214 included patients, a NACT was concomitantly prescribed to 155 patients (72%), with a median number of 5 NACTs per patient (range: 1-12). The most prescribed drugs were anti-hypertensive drugs (101 patients, 47.2%), psychotropic drugs (n = 74, 34.6%), analgesics (n = 78, 36.4%), hypolipidemic drugs (n = 57, 26.6%), proton pump inhibitors (n = 46, 21.5%) and antiplatelet drugs (n = 38, 17.8%). Although 833 different molecules were reported, only 20 possible modifiers of cancer biological pathways (prescribed to 74 patients (34.5%)) were identified. Eight out of the 833 molecules (0.9%), belonging to six drug families, have been investigated in 28 ongoing or published clinical trials in combo with radiotherapy. They were prescribed to 63 patients (29.4%).

Conclusion: Drug-radiation interaction remains a subject of major interest, not only for conventional anticancer drugs, but also for NACTs. New trial designs are thus required.

Keywords: Clinical trials; Non-anti-cancer treatments; Oncogenic pathways; Radiation therapy; Treatment interactions.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics / adverse effects
  • Antihypertensive Agents / adverse effects
  • Cross-Sectional Studies
  • Drug Interactions
  • Female
  • Humans
  • Hypolipidemic Agents / adverse effects
  • Male
  • Middle Aged
  • Neoplasms / radiotherapy*
  • Platelet Aggregation Inhibitors / adverse effects
  • Prospective Studies
  • Proton Pump Inhibitors / adverse effects
  • Psychotropic Drugs / adverse effects

Substances

  • Analgesics
  • Antihypertensive Agents
  • Hypolipidemic Agents
  • Platelet Aggregation Inhibitors
  • Proton Pump Inhibitors
  • Psychotropic Drugs