Drug interactions in aging and cancer

Abstract

Potential drug interactions (PDIs) can lead to adverse drug events (ADEs), which can be a source of potential morbidity, disability, and mortality among older adults. Older adults with cancer may be more susceptible to the negative impact of PDIs due to increased medications warranted as part of their cancer treatment (including symptom management and supportive care for the treatment plan). Polypharmacy is a geriatric syndrome that has led to increased complications among older adults with and without cancer and increases the risk of both PDIs and ADEs. Although several PDIs can be of unclear clinical significance when encountered, they may be more of an issue with competing medications used for comorbidities that face older adults with cancer. Moreover, this risk may be further augmented when the cancer treatment regimen is orally administered. The consequences of these types of PDIs may have more significant “downstream” effects on treatment adherence and persistence. However, as more anticancer drugs become available and adopted into clinical practice (particularly oral agents), additional studies will need to address PDIs within the dynamic landscape of cancer therapeutics and their impact on older adults with cancer who are at increased risk of toxicities.