Therapeutic Drug-Drug Interactions (DDIs) Causing QT Prolongation in Patients With Cancer: A Systematic Review and Meta-Analysis.

Abstract

Therapeutic drug-drug interactions (DDIs) have the potential to harm the patient by causing serious and unwanted side effects. Patients suffering from cancer are exposed to numerous drugs, such as therapeutic drugs and adjuvant treatments for the comorbidities and the side effects of chemotherapy. The concomitant use of anticancer and adjuvant drugs makes such patients prone to QT prolongation, which could precipitate torsades de pointes or TdP. The current review aims to summarize the prevalence of therapeutic DDIs causing QT prolongation in these patients. A thorough literature search was performed using databases such as PubMed, Google Scholar, and Research Gate. Medical Subject Headings (MeSH) and alternate search terminologies such as "QT prolongation", "Drug interactions", and "Cancer" were used to identify all the relevant articles published in English to date. The data from all such published articles available on the day of the collection were considered and fed into the meta package of R software for measuring the outcomes. The literature search yielded seven unique and relevant articles, which were included in our study. In these studies, therapeutic DDIs causing QT prolongation were found to occur in 3558 out of 8013 patients undergoing evaluation. Their prevalence in patients with cancer was estimated to be 22% with a 95% CI between 4% and 63%. The patient characteristics, such as age, comorbid diseases, drugs for supportive care, and polypharmacy, were identified as risk factors associated with potential DDIs. Our data concluded that 22% of the patients administered anticancer drugs were exposed to concomitant drugs leading to DDIs, which prolonged the QT interval. Thus, the implementation of vigilant measures and precautionary safety interventions becomes vital to forestall QT prolongation and any other adverse cardiac events in this group of patients.