title: Tyrosine Kinase Inhibitors and Proton Pump Inhibitors: An Evaluation of Treatment Options.
abstract: Tyrosine kinase inhibitors (TKIs) have rapidly become an established factor in oncology, and have been shown to be effective in a wide variety of solid and hematologic malignancies. Use of the oral administration route of TKIs offers flexibility and is convenient for the patient; however, despite these advantages, the oral route of administration also causes a highly relevant new problem. Acid-inhibitory drugs, such as proton pump inhibitors (PPIs), increase the intragastric pH, which may subsequently decrease TKI solubility, bioavailability, and treatment efficacy. Clear and practical advice on how to manage PPI use during TKI therapy is currently not available in the literature. Since PPIs are extensively used during TKI therapy, prescribers are presented with a big dilemma as to whether or not to continue the combined treatment, resulting in patients possibly being deprived of optimal therapy. When all pharmacological characteristics and data of either TKIs and PPIs are considered, practical and safe advice on how to manage this drug combination can be given.
authors.affiliation: Department of Medical Oncology, Erasmus MC Cancer InstituteErasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. r.w.f.vanleeuwen@erasmusmc.nl.|Department of Hospital Pharmacy, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. r.w.f.vanleeuwen@erasmusmc.nl.
authors.forename: Roelof W F
authors.initials: RWF
authors.lastname: van Leeuwen
authors.affiliation: Department of Clinical Pharmacy, Deventer Hospital, Nico Bolkesteinlaan 75, 7416 SE, Deventer, The Netherlands.|Department of Pharmacotherapy, Epidemiology and Economics, University of Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
authors.forename: Frank G A
authors.initials: FGA
authors.lastname: Jansman
authors.affiliation: Department of Hospital Pharmacy, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.|Department of Intensive Care, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Nicole G
authors.initials: NG
authors.lastname: Hunfeld
authors.affiliation: Department of Pulmonary Medicine, Erasmus MC Cancer Institute, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Robert
authors.initials: R
authors.lastname: Peric
authors.affiliation: Department of Medical Oncology, University Medical Center Groningen, A. Deusinglaan 1, 9712 CP, Groningen, The Netherlands.
authors.forename: Anna K L
authors.initials: AKL
authors.lastname: Reyners
authors.affiliation: Department of Medical Oncology, Deventer Hospital, Nico Bolkesteinlaan 75, 7416 SE, Deventer, The Netherlands.
authors.forename: Alex L T
authors.initials: ALT
authors.lastname: Imholz
authors.affiliation: Department of Pharmacotherapy, Epidemiology and Economics, University of Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
authors.forename: Jacobus R B J
authors.initials: JRBJ
authors.lastname: Brouwers
authors.affiliation: Department of Pulmonary Medicine, Erasmus MC Cancer Institute, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Joachim G
authors.initials: JG
authors.lastname: Aerts
authors.affiliation: Department of Hospital Pharmacy, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.|Department of Internal Medicine, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Teun
authors.initials: T
authors.lastname: van Gelder
authors.affiliation: Department of Medical Oncology, Erasmus MC Cancer InstituteErasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Ron H J
authors.initials: RHJ
authors.lastname: Mathijssen
mesh_terms: D000284:Administration, Oral; D004347:Drug Interactions; D006801:Humans; D047428:Protein Kinase Inhibitors / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D054328:Proton Pump Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D047428:Protein Kinase Inhibitors; D054328:Proton Pump Inhibitors; D011505:Protein-Tyrosine Kinases