Researchers from Duke Health published a commentary in the Journal of Clinical Oncology warning that common over‑the‑counter and prescription medicines can alter cancer immunotherapy outcomes. Immunotherapy uses a patient’s immune system to fight cancer and can avoid some of the harsh side effects of chemotherapy. Lead author Nicholas DeVito, an assistant professor in the division of medical oncology at Duke University School of Medicine, said clinicians often miss interactions with the immune system.
The authors reviewed more than 50 studies and reported that some widely used drugs may reduce immunotherapy efficacy while others may enhance response. They also warn that certain medicines might cause or raise the rate of side effects. Examples cited in the commentary include drugs reported to reduce efficacy and drugs that may enhance effectiveness:
- Reduce efficacy: acetaminophen, proton pump inhibitors, corticosteroids.
- May enhance effectiveness: antihistamines, statins, selective serotonin reuptake inhibitors (SSRIs).
The researchers call for better recording of all medications, including over‑the‑counter drugs, prospective studies to confirm these influences, and practical tools such as patient education materials and prompts in electronic health records. DeVito’s work is supported by the Duke Strong Start award to help junior physician‑scientist faculty at the Duke University School of Medicine.
Difficult words
- immunotherapy — treatment that uses the immune system
- efficacy — ability of a treatment to work
- proton pump inhibitor — drug that reduces stomach acid productionproton pump inhibitors
- corticosteroid — type of drug that reduces inflammationcorticosteroids
- antihistamine — drug that blocks allergic reactions or symptomsantihistamines
- statin — drug used to lower blood cholesterol levelsstatins
- prospective study — research that follows people forward in timeprospective studies
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- How could better recording of all medications change the safety or success of immunotherapy for patients?
- What difficulties might researchers face when running prospective studies about drug effects on immunotherapy?
- If you or a family member were on immunotherapy, which over-the-counter medicines would you mention to the clinician and why?
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