Clinically Relevant Chemotherapy Interactions with Complementary and Alternative Medicines in Patients with Cancer

The study highlighted the prevalent use of complementary and alternative medicines (CAMs), particularly herbal medicines, by cancer patients undergoing chemotherapy, and the potential for severe herb-drug interactions (HDIs). It categorized interactions into seven areas: cancer treatment and prevention, immune system, alopecia, nausea and vomiting, peripheral neuropathy and pain, inflammation, and fatigue. Pharmacokinetic interactions often involved cytochrome P450 isozymes and p-glycoprotein, while pharmacodynamic interactions included risks like central nervous system effects, hepatotoxicity, and bleeding. The study emphasized the need for clinicians to be vigilant and to select herb-drug pairs with lower interaction risks, alongside close monitoring of pharmacological effects and plasma drug levels to prevent toxicity and ensure effective chemotherapy.