Journals / Hacettepe Üniversitesi Eczacılık Fakültesi Dergisi / 2026 / Volume: 45 Issue: 1

Common Drug-Drug and Drug-Food Interactions in Antineoplastic Agents: A short update review

Sonia Sanajou(İSTANBUL AYDIN ÜNİVERSİTESİ)0000-0002-6751-5266
Terken Baydar(HACETTEPE UNIVERSITY, INSTITUTE OF HEALTH SCIENCES, PHARMACEUTICAL TOXICOLOGY (DR))0000-0002-5497-9600
Pages
—
Publication Date
2025-03-01
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

By addressing these interactions, healthcare providers can mitigate risks, improve therapeutic outcomes, and enhance the quality of life for cancer patients.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Cancer treatment regimens often combine chemotherapeutics, supportive therapies, and medications for comorbidities, increasing the risk of drug-drug (DDIs) and drug-food interactions (DFIs).
📊
Key Findings & Data:Clinically relevant examples are provided to illustrate these interactions.
💡
Conclusion & Impact:By addressing these interactions, healthcare providers can mitigate risks, improve therapeutic outcomes, and enhance the quality of life for cancer patients.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Drug-Drug interaction · Food-Drug interaction · Oncology

Abstract

Cancer treatment regimens often combine chemotherapeutics, supportive therapies, and medications for comorbidities, increasing the risk of drug-drug (DDIs) and drug-food interactions (DFIs). These interactions can alter the pharmacokinetics and pharmacodynamics of anticancer agents, potentially leading to treatment failure, severe adverse events, or hospitalization. Elderly patients, polypharmacy, and the narrow therapeutic index of many chemotherapeutics further compound these challenges. This review explores the mechanisms underlying DDIs and DFIs, focusing on absorption, metabolism, and transport protein modulation—key processes influencing drug bioavailability and toxicity in oncology. Clinically relevant examples are provided to illustrate these interactions. The review underscores the critical role of pharmacy services in identifying, preventing, and managing these interactions, offering actionable strategies to enhance patient safety and treatment efficacy. By addressing these interactions, healthcare providers can mitigate risks, improve therapeutic outcomes, and enhance the quality of life for cancer patients.

🔖

Cite This Article

Sanajou, S., Baydar, T. (2025). Common Drug-Drug and Drug-Food Interactions in Antineoplastic Agents: A short update review. Hacettepe Üniversitesi Eczacılık Fakültesi Dergisi, Volume: 45 Issue: 1. https://doi.org/10.52794/hujpharm.1602716

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (101)

  1. Gilad Y, Gellerman G, Lonard DM, O’Malley BW. Drug Combination in Cancer Treatment—From Cocktails to Conjugated Combinations. Cancers. 2021;13:669. https://doi.org/10.3390/cancers13040669
  2. Bibi R, Azhar S, Iqbal A, Jabeen H, Kalsoom U-E, Iqbal MM, et al. Prevalence of potential drug-drug interactions in breast cancer patients and determination of their risk factors. J Oncol Pharm Pract Off Publ Int Soc Oncol Pharm Pract. 2021;27:1616–22. https://doi.org/10.1177/1078155220963212
  3. Koni AA, Nazzal MA, Suwan BA, Sobuh SS, Abuhazeem NT, Salman AN, et al. A comprehensive evaluation of potentially significant drug-drug, drug-herb, and drug-food interactions among cancer patients receiving anticancer drugs. BMC Cancer. 2022;22:547. https://doi.org/10.1186/s12885-022-09649-3.
  4. Oliveira RF, Oliveira AI, Cruz AS, Ribeiro O, Afreixo V, Pimentel F. Polypharmacy and drug interactions in older patients with cancer receiving chemotherapy: associated factors. BMC Geriatr. 2024;24:557. https://doi.org/10.1186/s12877-024-05135-6
  5. Sharma A, Jasrotia S, Kumar A. Effects of Chemotherapy on the Immune System: Implications for Cancer Treatment and Patient Outcomes. Naunyn Schmiedebergs Arch Pharmacol. 2024;397:2551–66. https://doi.org/10.1007/s00210-023-02781-2
  6. Amjad MT, Chidharla A, Kasi A. Cancer Chemotherapy. Stat- Pearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Nov 14]. Available from: http://www.ncbi. nlm.nih.gov/books/NBK564367/
  7. Joshi DC, Sharma A, Prasad S, Singh K, Kumar M, Sherawat K, et al. Novel therapeutic agents in clinical trials: emerging approaches in cancer therapy. Discov Oncol. 2024;15:342. https://doi.org/10.1007/s12672-024-01195-7
  8. Badheeb AM, Ahmed F, Alzahrani HA, Badheeb MA, Obied HY, Seada IA. Cancer Therapy-Related Cardiotoxicity: A Comprehensive Retrospective Analysis at Najran Cancer Center, Saudi Arabia. Cureus. 2023;15:e41287. https://doi. org/10.7759/cureus.41287
  9. Anand U, Dey A, Chandel AKS, Sanyal R, Mishra A, Pandey DK, et al. Cancer chemotherapy and beyond: Current status, drug candidates, associated risks and progress in targeted therapeutics. Genes Dis. 2022;10:1367–401. https://doi. org/10.1016/j.gendis.2022.02.007
  10. Gonçalves-Nobre JG, Gaspar I, Alpuim Costa D. Anthracyclines and trastuzumab associated cardiotoxicity: is the gut microbiota a friend or foe? – a mini-review. Front Microbiomes [Internet]. 2023 [cited 2025 Feb 23];2. https://doi.org/10.3389/ frmbi.2023.1217820
  11. Hassen G, Belete G, Carrera KG, Iriowen RO, Araya H, Alemu T, et al. Clinical Implications of Herbal Supplements in Conventional Medical Practice: A US Perspective. Cureus. 2022;14:e26893. https://doi.org/10.7759/cureus.26893
  12. Du M, Luo H, Blumberg JB, Rogers G, Chen F, Ruan M, et al. Dietary Supplement Use among Adult Cancer Survivors in the United States. J Nutr. 2020;150:1499–508. https://doi. org/10.1093/jn/nxaa040
  13. Giuliano C, McConachie S, Kalabalik-Hoganson J. Multicenter randomized comparative trial of Micromedex, Micromedex with Watson, or Google to answer drug information questions. J Med Libr Assoc. 2021;109:212–8. https://doi.org/10.5195/ jmla.2021.1085
  14. Andrés CMC, Pérez de la Lastra JM, Munguira EB, Andrés Juan C, Pérez-Lebeña E. Dual-Action Therapeutics: DNA Alkylation and Antimicrobial Peptides for Cancer Therapy. Cancers. 2024;16:3123. https://doi.org/10.3390/cancers16183123
  15. Lossos C, Liu Y, Kolb KE, Christie AL, Van Scoyk A, Prakadan SM, et al. Mechanisms of lymphoma clearance induced by high-dose alkylating agents. Cancer Discov. 2019;9:944–61. https://doi.org/10.1158/2159-8290.CD-18-1393
  16. Abotaleb M, Kubatka P, Caprnda M, Varghese E, Zolakova B, Zubor P, et al. Chemotherapeutic agents for the treatment of metastatic breast cancer: An update. Biomed Pharmacother. 2018;101:458–77. https://doi.org/10.1016/j.biopha. 2018.02.108
  17. Wang F, Zhang X, Wang Y, Chen Y, Lu H, Meng X, et al. Activation/Inactivation of Anticancer Drugs by CYP3A4: Influencing Factors for Personalized Cancer Therapy. Drug Metab Dispos. 2023;51:543–59. https://doi.org/10.1124/ dmd.122.001131
  18. Syrigou E, Makrilia N, Koti I, Saif MW, Syrigos KN. Hypersensitivity reactions to antineoplastic agents: an overview. Anticancer Drugs. 2009;20:1. https://doi.org/10.1097/ CAD.0b013e32831961b3
  19. Zhao G, Wang Q, Li S, Wang X. Resistance to Hypomethylating Agents in Myelodysplastic Syndrome and Acute Myeloid Leukemia From Clinical Data and Molecular Mechanism. Front Oncol [Internet]. 2021 [cited 2025 Feb 22];11. https:// doi.org/10.3389/fonc.2021.706030
  20. Emadi, A, Karp JE. Cancer Pharmacology: An Illustrated Manual of Anticancer Drugs. Springer Publishing Company; 2023.
  21. Booser DJ, Hortobagyi GN. Anthracycline antibiotics in cancer therapy. Focus on drug resistance. Drugs. 1994;47:223–58. https://doi.org/10.2165/00003495-199447020-00002
  22. Kciuk M, Marciniak B, Kontek R. Irinotecan—Still an Important Player in Cancer Chemotherapy: A Comprehensive Overview. Int J Mol Sci. 2020;21:4919. https://doi.org/10.3390/ ijms21144919
  23. de With M, van Doorn L, Kloet E, van Veggel A, Matic M, de Neijs MJ, et al. Irinotecan-Induced Toxicity: A Pharmacogenetic Study Beyond UGT1A1. Clin Pharmacokinet. 2023;62:1589–97. https://doi.org/10.1007/s40262-023- 01279-7
  24. Xu AP, Xu LB, Smith ER, Fleishman JS, Chen Z-S, Xu X-X. Cell death in cancer chemotherapy using taxanes. Front Pharmacol. 2023;14:1338633. https://doi.org/10.1111/cts.70043
  25. Abal M, Andreu JM, Barasoain I. Taxanes: Microtubule and Centrosome Targets, and Cell Cycle Dependent Mechanisms of Action. http://www.eurekaselect.com [Internet]. 2003 [cited 2025 Feb 22]; Available from: https://www.eurekaselect. com/article/8787
  26. Ismail U, Killeen RB. Taxane Toxicity. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Feb 22]. Available from: http://www.ncbi.nlm.nih.gov/books/ NBK589655/
  27. Škubník J, Pavlíčková VS, Ruml T, Rimpelová S. Vincristine in Combination Therapy of Cancer: Emerging Trends in Clinics. Biology. 2021;10:849. https://doi.org/10.3390/biology10090849
  28. Awosika AO, Below J, Das JM. Vincristine. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Nov 14]. Available from: http://www.ncbi.nlm.nih.gov/ books/NBK537122/
  29. Jinna S, Khandhar PB. Hydroxyurea Toxicity. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Nov 14]. Available from: http://www.ncbi.nlm.nih. gov/books/NBK537209/
  30. Yoham AL, Casadesus D. Tretinoin. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Nov 14]. Available from: http://www.ncbi.nlm.nih.gov/books/ NBK557478/
  31. Leu L, Mohassel L. Arsenic trioxide as first-line treatment for acute promyelocytic leukemia. Am J Health-Syst Pharm AJHP Off J Am Soc Health-Syst Pharm. 2009;66:1913–8. https://doi.org/10.2146/ajhp080342
  32. Field-Smith A, Morgan GJ, Davies FE. Bortezomib (VelcadeTM) in the Treatment of Multiple Myeloma. Ther Clin Risk Manag. 2006;2:271. https://doi.org/10.2147/tcrm.2006.2.3.271
  33. Zhang Y, Zhang Z. The history and advances in cancer immunotherapy: understanding the characteristics of tumor-infiltrating immune cells and their therapeutic implications. Cell Mol Immunol. 2020;17:807–21. https://doi.org/10.1038/s41423-020-0488-6
  34. Bergholz JS, Wang Q, Kabraji S, Zhao JJ. Integrating immunotherapy and targeted therapy in cancer treatment: mechanistic insights and clinical implications. Clin Cancer Res Off J Am Assoc Cancer Res. 2020;26:5557–66. https://doi. org/10.1158/1078-0432.CCR-19-2300
  35. Shuel SL. Targeted cancer therapies. Can Fam Physician. 2022;68:515–8. https://doi.org/10.46747/cfp.6807515
  36. Ebrahimi N, Fardi E, Ghaderi H, Palizdar S, Khorram R, Vafadar R, et al. Receptor tyrosine kinase inhibitors in cancer. Cell Mol Life Sci CMLS. 2023;80:104. https://doi.org/10.1007/ s00018-023-04729-4
  37. Cho JH, Lim SH, An HJ, Kim KH, Park KU, Kang EJ, et al. Osimertinib for Patients With Non–Small-Cell Lung Cancer Harboring Uncommon EGFR Mutations: A Multicenter, Open-Label, Phase II Trial (KCSG-LU15-09). J Clin Oncol. 2020;38:488–95. https://doi.org/10.1200/JCO.19.00931
  38. Wang Z, Zheng Z, Jia S, Liu S, Xiao X, Chen G, et al. Trastuzumab resistance in HER2-positive breast cancer: Mechanisms, emerging biomarkers and targeting agents. Front Oncol. 2022;12:1006429. https://doi.org/10.3389/fonc.2022.1006429
  39. Chidharla A, Parsi M, Kasi A. Cetuximab. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Feb 23]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK459293/
  40. Kazazi-Hyseni F, Beijnen JH, Schellens JHM. Bevacizumab. The Oncologist. 2010;15:819–25. https://doi.org/10.1634/theoncologist. 2009-0317
  41. Tonon G, Rizzolio F, Visentin F, Scattolin T. Antibody Drug Conjugates for Cancer Therapy: From Metallodrugs to Nature- Inspired Payloads. Int J Mol Sci. 2024;25:8651. https://doi.org/10.3390/ijms25168651
  42. Martín M, Pandiella A, Vargas-Castrillón E, Díaz-Rodríguez E, Iglesias-Hernangómez T, Martínez Cano C, et al. Trastuzumab deruxtecan in breast cancer. Crit Rev Oncol Hematol. 2024;198:104355. https://doi.org/10.1016/j.critrevonc. 2024.104355
  43. Bhatt S, Ashlock BM, Natkunam Y, Sujoy V, Chapman JR, Ramos JC, et al. CD30 targeting with brentuximab vedotin: a novel therapeutic approach to primary effusion lymphoma. Blood. 2013;122:1233–42. https://doi.org/10.1182/blood- 2013-01-481713
  44. Bondar D, Karpichev Y. Poly(ADP-Ribose) Polymerase (PARP) Inhibitors for Cancer Therapy: Advances, Challenges, and Future Directions. Biomolecules. 2024;14:1269. https:// doi.org/10.3390/biom14101269
  45. Jain A, Barge A, Parris CN. Combination strategies with PARP inhibitors in BRCA-mutated triple-negative breast cancer: overcoming resistance mechanisms. Oncogene. 2025;44:193– 207. https://doi.org/10.1038/s41388-024-03227-6
  46. Wang SSY, Jie YE, Cheng SW, Ling GL, Ming HVY. PARP Inhibitors in Breast and Ovarian Cancer. Cancers. 2023;15:2357. https://doi.org/10.3390/cancers15082357
  47. Liu Z-L, Chen H-H, Zheng L-L, Sun L-P, Shi L. Angiogenic signaling pathways and anti-angiogenic therapy for cancer. Signal Transduct Target Ther. 2023;8:1–39. https://doi. org/10.1038/s41392-023-01460-1
  48. Gerriets V, Kasi A. Bevacizumab. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Feb 23]. Available from: http://www.ncbi.nlm.nih.gov/books/ NBK482126/
  49. Shiravand Y, Khodadadi F, Kashani SMA, Hosseini-Fard SR, Hosseini S, Sadeghirad H, et al. Immune Checkpoint Inhibitors in Cancer Therapy. Curr Oncol. 2022;29:3044–60. https:// doi.org/10.3390/curroncol29050247
  50. He X, Xu C. Immune checkpoint signaling and cancer immunotherapy. Cell Res. 2020;30:660–9. https://doi.org/10.1038/ s41422-020-0343-4
  51. Wojtukiewicz MZ, Rek MM, Karpowicz K, Górska M, Polityńska B, Wojtukiewicz AM, et al. Inhibitors of immune checkpoints—PD-1, PD-L1, CTLA-4—new opportunities for cancer patients and a new challenge for internists and general practitioners. Cancer Metastasis Rev. 2021;40:949–82. https:// doi.org/10.1007/s10555-021-09976-0
  52. Feins S, Kong W, Williams EF, Milone MC, Fraietta JA. An introduction to chimeric antigen receptor (CAR) T-cell immunotherapy for human cancer. Am J Hematol. 2019;94:S3–9. https://doi.org/10.1002/ajh.25418
  53. Sterner RC, Sterner RM. CAR-T cell therapy: current limitations and potential strategies. Blood Cancer J. 2021;11:1–11. https://doi.org/10.1038/s41408-021-00459-7
  54. Vaidyanathan G, Dy GK. Toxicities of Targeted Therapies and Their Management. J Target Ther Cancer [Internet]. 2014 [cited 2025 Feb 23];2. Available from: https://www.targetedonc. com/view/toxicities-of-targeted-therapies-and-theirmanagement
  55. Ramos-Casals M, Brahmer JR, Callahan MK, Flores-Chávez A, Keegan N, Khamashta MA, et al. Immune-related adverse events of checkpoint inhibitors. Nat Rev Dis Primer. 2020;6:38. https://doi.org/10.1038/s41572-020-0160-6
  56. de Jonge ME, Huitema AD, Schellens JH, Rodenhuis S, Beijnen JH. Population pharmacokinetics of orally administered paclitaxel formulated in Cremophor EL. Br J Clin Pharmacol. 2005;59:325–34. https://doi.org/10.1111/j.1365- 2125.2004.02325.x
  57. Chakraborti S, Stewart A, Maity B. Impact of Chemotherapeutic Drugs Towards Oxidative Stress and Associated Multi-organ Physiological Responses. In: Chakraborti S, editor. Handb Oxidative Stress Cancer Ther Asp [Internet]. Singapore: Springer; 2021 [cited 2025 Feb 23]. p. 1–25. Available from: https://doi.org/10.1007/978-981-16-1247-3_248-1
  58. Lyrio RM da C, Rocha BRA, Corrêa ALRM, Mascarenhas MGS, Santos FL, Maia R da H, et al. Chemotherapy-induced acute kidney injury: epidemiology, pathophysiology, and therapeutic approaches. Front Nephrol. 2024;4:1436896. https:// doi.org/10.3389/fneph.2024.1436896
  59. Pinkel D. The Use of Body Surface Area as a Criterion of Drug Dosage in Cancer Chemotherapy*. Cancer Res. 1958;18:853–6.
  60. Kaestner SA, Sewell GJ. Chemotherapy dosing part I: scientific basis for current practice and use of body surface area. Clin Oncol R Coll Radiol G B. 2007;19:23–37. https://doi. org/10.1016/j.clon.2006.10.010
  61. Koziolek M, Alcaro S, Augustijns P, Basit AW, Grimm M, Hens B, et al. The mechanisms of pharmacokinetic fooddrug interactions – A perspective from the UNGAP group. Eur J Pharm Sci. 2019;134:31–59. https://doi.org/10.1016/j. ejps.2019.04.003
  62. Flynn A, Galettis P, Gurney H, Michael M, Desar I, Westerdijk K, et al. Therapeutic drug monitoring in anticancer agents: perspectives of Australian medical oncologists. Intern Med J. 2024;54:1458–64. https://doi.org/10.1111/imj.16415
  63. Stielow M, Witczyńska A, Kubryń N, Fijałkowski Ł, Nowaczyk J, Nowaczyk A. The Bioavailability of Drugs—The Current State of Knowledge. Molecules. 2023;28:8038. https://doi.org/10.3390/molecules28248038
  64. Kambayashi A, Shirasaka Y. Food effects on gastrointestinal physiology and drug absorption. Drug Metab Pharmacokinet. 2023;48:100488. https://doi.org/10.1016/j.dmpk.2022.100488
  65. Devriese LA, Koch KM, Mergui-Roelvink M, Matthys GM, Ma WW, Robidoux A, et al. Effects of low-fat and highfat meals on steady-state pharmacokinetics of lapatinib in patients with advanced solid tumours. Invest New Drugs. 2014;32:481–8. https://doi.org/10.1007/s10637-013-0055-4
  66. Santana Martínez S, Marcos Rodríguez JA, Romero Carreño E. Oral chemotherapy: food-drug interactions. Farm Hosp Organo Of Expresion Cient Soc Espanola Farm Hosp. 2015;39:203–9. https://doi.org/10.7399/fh.2015.39.4.8883
  67. Fasinu PS, Rapp GK. Herbal Interaction With Chemotherapeutic Drugs—A Focus on Clinically Significant Findings. Front Oncol. 2019;9:1356. https://doi.org/10.3389/fonc.2019.01356
  68. Commissioner O of the. Grapefruit Juice and Some Drugs Don’t Mix. FDA [Internet]. 2021 [cited 2024 Nov 13]; Available from: https://www.fda.gov/consumers/consumer-updates/ grapefruit-juice-and-some-drugs-dont-mix
  69. Yin OQP, Gallagher N, Li A, Zhou W, Harrell R, Schran H. Effect of Grapefruit Juice on the Pharmacokinetics of Nilotinib in Healthy Participants. J Clin Pharmacol. 2010;50:188–94. https://doi.org/10.1177/0091270009336137
  70. Valenzuela B, Rebollo J, Pérez T, Brugarolas A, Pérez‐Ruixo JJ. Effect of grapefruit juice on the pharmacokinetics of docetaxel in cancer patients: a case report. Br J Clin Pharmacol. 2011;72:978–81. https://doi.org/10.1111/j.1365-2125.2011.04052.x
  71. Batiha GE-S, Beshbishy AM, Wasef LG, Elewa YHA, Al- Sagan AA, El-Hack MEA, et al. Chemical Constituents and Pharmacological Activities of Garlic (Allium sativum L.): A Review. Nutrients. 2020;12:872. https://doi.org/10.3390/nu12030872
  72. Hajda J, Rentsch KM, Gubler C, Steinert H, Stieger B, Fattinger K. Garlic extract induces intestinal P-glycoprotein, but exhibits no effect on intestinal and hepatic CYP3A4 in humans. Eur J Pharm Sci. 2010;41:729–35. https://doi.org/10.1016/j.ejps.2010.09.016
  73. Chen S, Wang Z, Huang Y, O’Barr SA, Wong RA, Yeung S, et al. Ginseng and Anticancer Drug Combination to Improve Cancer Chemotherapy: A Critical Review. Evid-Based Complement Altern Med ECAM. 2014;2014:168940. https://doi.org/10.1155/2014/168940
  74. Bilgi N, Bell K, Ananthakrishnan AN, Atallah E. Imatinib and Panax Ginseng: A Potential Interaction Resulting in Liver Toxicity. Ann Pharmacother. 2010;44:926–8. https://doi.org/10.1345/aph.1M715
  75. Talasaz AH, McGonagle B, HajiQasemi M, Ghelichkhan ZA, Sadeghipour P, Rashedi S, et al. Pharmacokinetic and Pharmacodynamic Interactions between Food or Herbal Products and Oral Anticoagulants: Evidence Review, Practical Recommendations, and Knowledge Gaps. Semin Thromb Hemost. 2024;s-0044-1790258. https://doi.org/10.1055/s-0044-1790258
  76. Hansen TS, Nilsen OG. In vitro CYP3A4 Metabolism: Inhibition by Echinacea purpurea and Choice of Substrate for the Evaluation of Herbal Inhibition. Basic Clin Pharmacol Toxicol. 2008;103:445–9. https://doi.org/10.1111/j.1742- 7843.2008.00307.x
  77. Le TT, McGrath SR, Fasinu PS. Herb-drug Interactions in Neuropsychiatric Pharmacotherapy – A Review of Clinically Relevant Findings. Curr Neuropharmacol. 2022;20:1736–51. https://doi.org/10.2174/1570159X19666210809100357
  78. Goey AKL, Meijerman I, Rosing H, Burgers JA, Mergui-Roelvink M, Keessen M, et al. The effect of Echinacea purpurea on the pharmacokinetics of docetaxel. Br J Clin Pharmacol. 2013;76:467–74. https://doi.org/10.1111/bcp.12159
  79. Borrelli F, Izzo AA. Herb–Drug Interactions with St John’s Wort (Hypericum perforatum): an Update on Clinical Observations. AAPS J. 2009;11:710. https://doi.org/10.1208/ s12248-009-9146-8
  80. Goey AKL, Meijerman I, Rosing H, Marchetti S, Mergui- Roelvink M, Keessen M, et al. The Effect of St John’s Wort on the Pharmacokinetics of Docetaxel. Clin Pharmacokinet. 2014;53:103–10. https://doi.org/10.1007/s40262-013-0102-5
  81. Mathijssen RHJ. Effects of St. John’s Wort on Irinotecan Metabolism. CancerSpectrum Knowl Environ. 2002;94:1247–9.https://doi.org/10.1093/jnci/94.16.1247
  82. Haouala A, Widmer N, Duchosal MA, Montemurro M, Buclin T, Decosterd LA. Drug interactions with the tyrosine kinase inhibitors imatinib, dasatinib, and nilotinib. Blood. 2011;117:e75–87. https://doi.org/10.1182/blood-2010-07-294330
  83. Emadi SA, Ghasemzadeh Rahbardar M, Mehri S, Hosseinzadeh H. A review of therapeutic potentials of milk thistle (Silybum marianum L.) and its main constituent, silymarin, on cancer, and their related patents. Iran J Basic Med Sci. 2022;25:1166– 76. https://doi.org/10.22038/IJBMS.2022.63200.13961
  84. Xie Y, Zhang D, Zhang J, Yuan J. Metabolism, Transport and Drug–Drug Interactions of Silymarin. Molecules. 2019;24:3693. https://doi.org/10.3390/molecules24203693
  85. Niu J, Straubinger RM, Mager DE. Pharmacodynamic Drug- Drug Interactions. Clin Pharmacol Ther. 2019;105:1395–406. https://doi.org/10.1002/cpt.1434
  86. Raoul JL, Moreau-Bachelard C, Gilabert M, Edeline J, Frénel JS. Drug–drug interactions with proton pump inhibitors in cancer patients: an underrecognized cause of treatment failure. ESMO Open. 2023;8:100880. https://doi.org/10.1016/j.esmoop. 2023.100880
  87. van Leeuwen R. Drug-Drug Interactions in Patients Treated with Anti-Cancer Agents [Internet]. [Mede mogelijk is gemaakt door Stichting de Merel, Stichting Coolsingel, Pfizer B.V., Boehringer Ingelheim, Bayer B.V., Astra Zenica, Sanofi Aventis en Astellas Pharma B.V.]: Colophon; 2016. Available from: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/ https://repub.eur.nl/pub/80060/Proefschrift.RvL.pdf
  88. Ruplin A, Segal E, McFarlane T. Review of drugdrug interactions in patients with prostate cancer. J Oncol Pharm Pract. 2024;30:1057–72. https://doi. org/10.1177/10781552241238198
  89. Perea JRA, Rada BSD de, Gandía ND. Comparative Pharmacology of Tyrosine Kinase Inhibitors for the Treatment of Chronic Myeloid Leukemia. Int J Clin Pharmacol Pharmacother [Internet]. 2018 [cited 2025 Feb 23];2018. https://doi. org/10.15344/2456-3501/2018/134
  90. Li Y, Kazuki Y, Drabison T, Kobayashi K, Fujita K, Xu Y, et al. Vincristine Disposition and Neurotoxicity Are Unchanged in Humanized CYP3A5 Mice. Drug Metab Dispos. 2024;52:80– 5. https://doi.org/10.1124/dmd.123.001466
  91. Deodhar M, Al Rihani SB, Arwood MJ, Darakjian L, Dow P, Turgeon J, et al. Mechanisms of CYP450 Inhibition: Understanding Drug-Drug Interactions Due to Mechanism-Based Inhibition in Clinical Practice. Pharmaceutics. 2020;12:846. https://doi.org/10.3390/pharmaceutics12090846
  92. Blum R, Seymour JF, Toner G. Significant impairment of high-dose methotrexate clearance following vancomycin administration in the absence of overt renal impairment. Ann Oncol. 2002;13:327–30. https://doi.org/10.1093/annonc/mdf021
  93. Pilla Reddy V, Bui K, Scarfe G, Zhou D, Learoyd M. Physiologically Based Pharmacokinetic Modeling for Olaparib Dosing Recommendations: Bridging Formulations, Drug Interactions, and Patient Populations. Clin Pharmacol Ther. 2019;105:229– 41. https://doi.org/10.1002/cpt.1103
  94. Kulkarni A, Singh J. Predicting drug–drug interactions in breast cancer patients treated with CDK4/6 inhibitors and forward planning. Expert Opin Drug Metab Toxicol. 2024;20:225–33. https://doi.org/10.1080/17425255.2024.2341810
  95. Goodman RS, Johnson DB, Balko JM. Corticosteroids and Cancer Immunotherapy. Clin Cancer Res Off J Am Assoc Cancer Res. 2023;29:2580–7. https://doi.org/10.1158/1078- 0432.CCR-22-3181
  96. Kotch C, Barrett D, Teachey DT. Tocilizumab for the treatment of chimeric antigen receptor T cell-induced cytokine release syndrome. Expert Rev Clin Immunol. 2019;15:813–22. https://doi.org/10.1080/1744666X.2019.1629904
  97. Lopez-Martin C, Garrido Siles M, Alcaide-Garcia J, Faus Felipe V. Role of clinical pharmacists to prevent drug interactions in cancer outpatients: a single-centre experience. Int J Clin Pharm. 2014;36:1251–9. https://doi.org/10.1007/s11096-014- 0029-4
  98. Nolazco JI, Chang SL. The role of health-related quality of life in improving cancer outcomes. J Clin Transl Res. 2023;9:110–4.
  99. Kim B, Lee J, Jang H, Lee N, Mehta J, Jang SB. Effects of Acid-Reducing Agents on the Pharmacokinetics of Lazertinib in Patients with EGFR Mutation-Positive Advanced Non- Small-Cell Lung Cancer. Adv Ther. 2022;39:4757–71. https:// doi.org/10.1007/s12325-022-02286-z
  100. Ismail M, Khan S, Khan F, Noor S, Sajid H, Yar S, et al. Prevalence and significance of potential drug-drug interactions among cancer patients receiving chemotherapy. BMC Cancer. 2020;20:335. https://doi.org/10.1186/s12885-020-06855-9
  101. Bilgi N, Bell K, Ananthakrishnan AN, Atallah E. Imatinib and Panax Ginseng: A Potential Interaction Resulting in Liver Toxicity. Ann Pharmacother. 2010;44:926–8. https://doi.org/10.1345/aph.1M715