Clinical implications of food-drug interactions with small-molecule kinase inhibitors

G D Marijn Veerman*, Koen G A M Hussaarts, Frank G A Jansman, Stijn W L Koolen, Roelof W F van Leeuwen, Ron H J Mathijssen

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

23 Citations (Scopus)
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Abstract

During the past two decades, small-molecule kinase inhibitors have proven to be valuable in the treatment of solid and haematological tumours. However, because of their oral administration, the intrapatient and interpatient exposure to small-molecule kinase inhibitors (SMKIs) is highly variable and is affected by many factors, such as concomitant use of food and herbs. Food-drug interactions are capable of altering the systemic bioavailability and pharmacokinetics of these drugs. The most important mechanisms underlying food-drug interactions are gastrointestinal drug absorption and hepatic metabolism through cytochrome P450 isoenzymes. As food-drug interactions can lead to therapy failure or severe toxicity, knowledge of these interactions is essential. This Review provides a comprehensive overview of published studies involving food-drug interactions and herb-drug interactions for all registered SMKIs up to Oct 1, 2019. We critically discuss US Food and Drug Administration (FDA) and European Medicines Agency (EMA) guidelines concerning food-drug interactions and offer clear recommendations for their management in clinical practice.

Original languageEnglish
Pages (from-to)E265-E279
Number of pages15
JournalLancet Oncology
Volume21
Issue number5
DOIs
Publication statusPublished - May-2020

Keywords

  • SINGLE-DOSE PHARMACOKINETICS
  • ST-JOHNS-WORT
  • LOW-FAT MEAL
  • ORAL BIOAVAILABILITY
  • GRAPEFRUIT JUICE
  • PHASE-I
  • ABSOLUTE BIOAVAILABILITY
  • ANTICANCER AGENTS
  • ALK INHIBITOR
  • HEALTHY

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