Clinical implications of the Drug-Drug Interaction in Cancer Patients treated with innovative oncological treatments

In the last two-decades, innovative drugs have revolutionized cancer treatments, demonstrating a significant improvement in overall survival. These drugs may present several pharmacokinetics interactions with non-oncological drugs, and vice versa, and, non-oncological drugs can modify oncological treatment outcome both with pharmacokinetic interaction and with an “off-target impact” on the tumor microenvironment or on the peripheral immune response. It’s supposed that the presence of a drug-drug interaction (DDI) is associated with an increased risk of reduced anti-tumor effects or severe toxicities. However, clinical evidence that correlate the DDI presence with outcome are few, and results are difficult to compare because of difference in data collection and heterogeneous population. This review reports all the clinical evidence about DDI to provide an easy-to-use guide for DDI management and dose adjustment in solid tumors treated with inhibitors of the cyclin-dependent kinases CDK4–6, Antibody-drug conjugates, Poly ADPribose polymerase inhibitors, androgen-receptor targeted agents, or immunecheckpoints inhibitors. [Display omitted] •Drug-Drug Interactions between cancer treatments and other medications may be associated with toxicities or reduced efficacy.•This review provides important recommendations to help physicians in clinical practice to prevent adverse events due to DDI.•The innovative oncological treatment analyzed in the present review are CDK4-6i, ADCs, PARPi, ARTA and ICIs.