title: The role of diet on the clinical pharmacology of oral antineoplastic agents.
abstract: OBJECTIVE
  The number of oral anticancer agents has greatly increased in recent years. It is a well-known fact that food intake can induce significant variations in the bioavailability of these drugs. The aim of this review is to describe the interactions between diet and oral anticancer drugs in terms of the possible effects of such interactions on reducing the antineoplastic activity of the drug or increasing its side effects.
  
  
  METHODS
  This was an analytical study of the numerous mechanisms leading to changes in the bioavailability of oral antineoplastic agents due to diet.
  
  
  RESULTS
  Food-drug interactions can induce a delay, decrease or increase in the absorption of the oral chemotherapeutic agent. The concomitant intake of food and antineoplastic drugs influence the pharmacokinetic and pharmacodynamic drug processes depending on the composition of the food consumed and the specific interactions of the food with transport mechanisms (p-glycoprotein, multidrug resistance proteins) and intestinal enzymatic systems (cytochrome P450).
  
  
  CONCLUSIONS
  In prescribing an oral anticancer agent, clinicians must consider the possibility that the consumption of specific food items has the potential to interfere with the pharmacokinetics and pharmacodynamics of the prescribed drug.
authors.affiliation: Division of Paediatric Oncology, Catholic University of Rome-A. Gemelli Hospital, Largo A. Gemelli 8, 00168 Rome, Italy. ruggiero@rm.unicatt.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Ruggiero
authors.forename: Maria G
authors.initials: MG
authors.lastname: Cefalo
authors.forename: Paola
authors.initials: P
authors.lastname: Coccia
authors.forename: Stefano
authors.initials: S
authors.lastname: Mastrangelo
authors.forename: Palma
authors.initials: P
authors.lastname: Maurizi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Riccardi
mesh_terms: D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D001682:Biological Availability; D004032:Diet; D018565:Food-Drug Interactions; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy / Q000378:metabolism*
chemical_list: D000970:Antineoplastic Agents