Toxicity of antineoplastic drug mixtures

Abstract

Securing potable water and preserving aquatic ecosystems are growing problems that will become even more important in the near future. Well-defined environmental pollutants such as pesticides, heavy metals, or organic matter have been thoroughly examined, but over the recent decade, a spotlight was put on a new and emerging group of pollutants - pharmaceuticals, antineoplastic drugs being considered as the most hazardous ones among these. Patients’ excretion is the most important routes by which antineoplastic residues end up in the effluents from hospitals and households and reach freshwater where aquatic organisms can be affected. Low concentrations of antineoplastic drug can be expected in occupational settings, and medical staff could be chronically exposed to these highly active agents, representing a potential threat to their health. The development of more sensitive analytical methods facilitated the detection of lower concentrations of antineoplastic drugs in the environment, which triggered the research of their toxicological effects on different organisms. Most studies usually focus on single compound toxicity, but due to the complexity of environmental exposure, the era of mixture testing has begun. In this chapter, we will focus on the toxicity of mixtures of the most commonly used antineoplastic drugs with different modes of action (5-fluorouracil, cisplatin, etoposide, imatinib mesylate, cyclophosphamide, etc.) and their transformation products toward different experimental models (bacteria, algae, animals, plants, and human cells).