Oral oncolytic and antiretroviral therapy administration: dose adjustments, drug interactions, and other considerations for clinical use

Drugs in Context
Melissa E BadowskiJohn Dicristofano

Abstract

The rise in non-AIDS defining cancers (NADCs) is emerging as a leading cause of death for HIV and cancer patients. To address this, current literature and guidelines suggest the continuation of antiretroviral therapy (ART) with oral oncolytic agents to prevent adverse complications associated with HIV disease progression. However, such an approach has the potential for drug-drug interactions and adverse events for patients on such therapy. Further, recommendations on how to adjust these medications, when used concomitantly, are limited. As such, our purpose is to evaluate existing literature through such means as drug databases (e.g. Micromedex, Lexi-Comp, etc.) and package inserts along with PubMed/Medline, Embase, and Google Scholar databases to develop a reference tool for providers to utilize when there is a decision to treat a patient with ART and oral oncolytic agents concurrently. Our findings suggest that there are many drug interactions that should be taken into consideration with dual therapy. Metabolism is a key determinant of dose adjustment, and many oncolytic agents and ART agents must have their dose adjusted as such. Most notably, several tyrosine kinase inhibitors require dose increases when used with non-nucle...Continue Reading

Citations

Dec 19, 2019·Expert Opinion on Drug Metabolism & Toxicology·Laureen A LammersJohannes A Romijn
Aug 20, 2019·Therapeutic Drug Monitoring·Ramon R ContrucciLaura Hondebrink
Feb 24, 2020·Clinical Breast Cancer·Zoé GuillaumeAudrey Simonaggio
Aug 31, 2021·Current Opinion in HIV and AIDS·Salin NheanDavid Back
Oct 13, 2021·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Mario Jorge Sobreira da SilvaAnnemeri Livinalli

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