Thu-Lan T. Luonga; Chelsea N. Powers, PhDa; Brian J. Reinhardt, MSa; Michael J. McAnulty, PhDa; Peter J. Weina, MDb; Karen J. Shou, DOa; Caban B. Ambar, MSa
Correspondence: Thu-Lan T. Luong (thu-lan.t.luong.civ@health.mil)
aWalter Reed National Military Medical Center, Bethesda, Maryland
bFort Belvoir Community Hospital, Virginia
Author disclosures
The authors report no actual or potential conflicts of interest or outside sources of funding with regard to this article.
Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the Department of Defense, the US Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review the complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.
Ethics and consent
The study protocol was approved by the Walter Reed National Military Medical Center Institutional Review Board and complied with the Health Insurance Portability and Accountability Act as an exempt protocol.
This retrospective study describes erlotinib and gefitinib use in the MHS and their potential for DDIs. Because of military service requirements, people who are qualified to serve must be healthy or have either controlled or nonactive medical diagnoses and be physically fit. Consequently, our patient population had fewer common medical illnesses, such as diabetes and obesity, compared with the general population. Most noncancer drugs mentioned in this study are not known CYP metabolizers; therefore, recorded AEs alone cannot conclusively determine whether there is a DDI among erlotinib or gefitinib and noncancer drugs. Antidepressants generally are safe but have boxed warnings in the US for increased risk of suicidal ideation in young people.53,54 This retrospective study did not find statistically significant DDIs for erlotinib or gefitinib with antidepressants. Based on this retrospective data analysis, futurein vitro testing is needed to assess DDIs for erlotinib or gefitinib and cancer or noncancer drugs identified in this study.
Acknowledgments
The Department of Research Program funds at Walter Reed National Military Medical Center supported this protocol. We sincerely appreciate the contribution of data extraction from the Joint Pathology Center teams (Francisco J. Rentas, John D. McGeeney, Kimberly M. Greenfield, Beatriz A. Hallo, and Johnny P. Beason) and the MHS database personnel (Maj Ryan Costantino, Lee Ann Zarzabal, Brandon Jenkins, and Alex Rittel). We gratefully thank you for the protocol support from the Department of Research programs: CDR Wesley R. Campbell, CDR Ling Ye, Yaling Zhou, Elizabeth Schafer, Robert Roogow, Micah Stretch, Diane Beaner, Adrienne Woodard, David L. Evers, and Paula Amann.
