Clinical implications of food-drug interactions with small-molecule kinase inhibitors

Marijn Veerman*, Koen Hussaarts, FGA Jansman, Stijn Koolen, Roelof van Leeuwen, Ron Mathijssen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

49 Citations (Scopus)


During the past two decades, small-molecule kinase inhibitors have proven to be valuable in the treatment of solid and haematological tumours. However, because of their oral administration, the intrapatient and interpatient exposure to small-molecule kinase inhibitors (SMKIs) is highly variable and is affected by many factors, such as concomitant use of food and herbs. Food–drug interactions are capable of altering the systemic bioavailability and pharmacokinetics of these drugs. The most important mechanisms underlying food–drug interactions are gastrointestinal drug absorption and hepatic metabolism through cytochrome P450 isoenzymes. As food–drug interactions can lead to therapy failure or severe toxicity, knowledge of these interactions is essential. This Review provides a comprehensive overview of published studies involving food–drug interactions and herb–drug interactions for all registered SMKIs up to Oct 1, 2019. We critically discuss US Food and Drug Administration (FDA) and European Medicines Agency (EMA) guidelines concerning food-drug interactions and offer clear recommendations for their management in clinical practice.

Original languageEnglish
Pages (from-to)e265-e279
JournalLancet Oncology
Issue number5
Publication statusPublished - May 2020

Bibliographical note

Funding Information:
FGAJ reports personal fees from Amgen and Genzyme, outside the submitted work. RHJM reports grants from Astellas, Bayer, Boehringer-Ingelheim, Cristal Therapeutics, Pfizer, Prostakan, Roche, and Pamgene; and grants and personal fees from Novartis and Servier, outside the submitted work. All other authors declare no competing interests.

Publisher Copyright:
© 2020 Elsevier Ltd

Research programs

  • EMC OR-01


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