Question ID: WS-101
Submitted by: Marie Hanigan
June 28, 2011
Question: Which concomitant medications taken by cancer patients potentiate, inactivate or alter the toxicity of the therapy? Studies of resistance to chemotherapy invariability assume that the resistance is due to genetic or epigenetic changes within the tumor. Yet, the metabolism and efficacy of many chemotherapy agents can be altered by concomitant medications. In clinical trials, there is a range of responses to the therapy even when all the patients in the treatment arm have the same type of tumor and equivalent stage of disease. Dramatic improvements in response may be possible if the concomitant medications are identified that correlate with enhanced response in clinical trials. Similarly, identifying concomitant medications that correlate with reduced response would also provide important data for improving treatment. Further studies could then be done to identify the mechanistic basis of the interaction. Several studies have shown that medication lists in patient’s charts are incomplete and often inaccurate. The incomplete medication lists in the medical records make it difficult to impossible to retrospectively investigate drug interactions. The clinical experiment is being done everyday across the country, but the data are not being collected. Patients in clincial trials are being treated with chemotherapy while on concomitant medications, but the information about the medications is not being accurately recorded in the medical charts. This is equivalent to doing a basic research study on the effectiveness of a chemotherapy agent in which some of the animals in each group are randomly given unknown doses of unknown drugs. There are several methods for improving the accuracy of medication lists.
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