[Drug interactions in uro-oncology].

BACKGROUND

Modern treatments in uro-oncology are increasingly based on therapeutics with complex metabolism in the human body and are associated with an increased risk of drug interactions.

OBJECTIVE

This article provides an overview of the most prevalent mechanisms of drug interaction within uro-oncologic therapies and points towards their potential management.

METHODS

Anti-cancer agents were compiled from the German National Guidelines for the respective indications. Metabolization pathways and potential for drug interactions for those therapeutic drugs as well as the most prevalent drugs for the treatment of concomitant conditions were collected through review of the German prescribing Information (Fachinfo®, www.fachinfo.de ) and an American-based drug information database (uptodate®, www.uptodate.com ). For the most frequent interactions, a pharmaceutical and medical assessment was performed.

RESULTS

For most anti-cancer agents, metabolization via CYP isoenzymes and transport proteins like p‑glycoprotein play a significant role.

CONCLUSION

Especially interactions with CYP enzymes like 3A4 are critical as they have potential repercussions on efficacy, safety, and quality of life. Clinical management of concomitant oral anticoagulation or in therapeutically limiting comorbidities (like immunosuppression) are particularly challenging.