The Role of CYP450 Drug Metabolism in Precision Cardio-Oncology. Int J Mol Sci 2020 Jan 17;21(2)
Date
01/23/2020Pubmed ID
31963461Pubmed Central ID
PMC7014347DOI
10.3390/ijms21020604Scopus ID
2-s2.0-85078262174 (requires institutional sign-in at Scopus site) 38 CitationsAbstract
As many novel cancer therapies continue to emerge, the field of Cardio-Oncology (or onco-cardiology) has become crucial to prevent, monitor and treat cancer therapy-related cardiovascular toxicity. Furthermore, given the narrow therapeutic window of most cancer therapies, drug-drug interactions are prevalent in the cancer population. Consequently, there is an increased risk of affecting drug efficacy or predisposing individual patients to adverse side effects. Here we review the role of cytochrome P450 (CYP450) enzymes in the field of Cardio-Oncology. We highlight the importance of cardiac medications in preventive Cardio-Oncology for high-risk patients or in the management of cardiotoxicities during or following cancer treatment. Common interactions between Oncology and Cardiology drugs are catalogued, emphasizing the impact of differential metabolism of each substrate drug on unpredictable drug bioavailability and consequent inter-individual variability in treatment response or development of cardiovascular toxicity. This inter-individual variability in bioavailability and subsequent response can be further enhanced by genomic variants in CYP450, or by modifications of CYP450 gene, RNA or protein expression or function in various 'omics' related to precision medicine. Thus, we advocate for an individualized approach to each patient by a multidisciplinary team with clinical pharmacists evaluating a treatment plan tailored to a practice of precision Cardio-Oncology. This review may increase awareness of these key concepts in the rapidly evolving field of Cardio-Oncology.
Author List
Fatunde OA, Brown SAMESH terms used to index this publication - Major topics in bold
Antineoplastic AgentsCardiotoxicity
Cardiovascular Diseases
Cytochrome P-450 Enzyme System
Drug Interactions
Drug-Related Side Effects and Adverse Reactions
Humans
Neoplasms
Pharmaceutical Preparations
Pharmacogenetics
Precision Medicine