Therapeutic Drug-Drug Interactions (DDIs) Causing QT Prolongation in Patients With Cancer - A Systematic Review and Meta-Analysis

Sep 23, 2026

Uploaded by Eliana

Therapeutic drug-drug interactions (DDIs) can harm cancer patients through serious, unwanted adverse effects, particularly by promoting QT prolongation. The review assesses how often therapeutic DDIs lead to QT prolongation in individuals receiving anticancer and adjuvant regimens, where concomitant use may trigger torsades de pointes (TdP). Databases including PubMed, Google Scholar, and ResearchGate were searched using MeSH terms and related keywords. Seven English-language studies were included, showing QT-prolongation DDIs in 3558 of 8013 patients, with prevalence estimated at 22% (95% CI 4%–63%).

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

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Abstract

Introduction and Background

Introduction

Review began 04/11/2025 Review ended 04/20/2025 Published 04/22/2025 © Copyright 2025 Ramasubbu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.82770 Open Access Review Article Therapeutic Drug-Drug Interactions (DDIs) Causing QT Prolongation in Patients With Cancer: A Systematic Review and Meta-Analysis Saravana Kumar Ramasubbu 1, Archana Mishra 2 , Soumitra Mandal 3, Chandrahasan K 1 , Prakash B M 4 1. Department of Pharmacology, Andaman and Nicobar Islands Institute of Medical Sciences, Sri Vijaya Puram, IND 2. Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND 3. Department of Pharmacology, All India Institute of Medical Sciences, Kalyani, Saguna, IND 4. Independent Practice, Pharmacology, Mysore, IND Corresponding author: Soumitra Mandal, [soumitra.habul@gmail.com](soumitra.habul@gmail.com) Abstract Therapeutic drug-drug interactions (DDIs) have the potential to harm the patient by causing serious and unwanted side effects. Patients suffering from cancer are exposed to numerous drugs, such as therapeutic drugs and adjuvant treatments for the comorbidities and the side effects of chemotherapy. The concomitant use of anticancer and adjuvant drugs makes such patients prone to QT prolongation, which could precipitate torsades de pointes or TdP. The current review aims to summarize the prevalence of therapeutic DDIs causing QT prolongation in these patients. A thorough literature search was performed using databases such as PubMed, Google Scholar, and Research Gate. Medical Subject Headings (MeSH) and alternate search terminologies such as “QT prolongation”,“Drug interactions”, and “Cancer” were used to identify all the relevant articles published in English to date. The data from all such published articles available on the day of the collection were considered and fed into the meta package of R software for measuring the outcomes. The literature search yielded seven unique and relevant articles, which were included in our study. In these studies, therapeutic DDIs causing QT prolongation were found to occur in 3558 out of 8013 patients undergoing evaluation. Their prevalence in patients with cancer was estimated to be 22% with a 95% CI between 4% and 63% . The patient characteristics, such as age, comorbid diseases, drugs for supportive care, and polypharmacy, were identified as risk factors associated with potential DDIs. Our data concluded that 22% of the patients administered anticancer drugs were exposed to concomitant drugs leading to DDIs, which prolonged the QT interval. Thus, the implementation of vigilant measures and precautionary safety interventions becomes vital to forestall QT prolongation and any other adverse cardiac events in this group of patients. Categories: Pharmacology, Oncology Keywords: adverse drug reactions, cancer patients, drug-drug interactions, prevalence, qt prolongation Introduction And Background Introduction The possibility of therapeutic drug-drug interactions (DDIs) and their aftereffects is a holy grail in clinical practice, and occurs when two or more drugs are administered concomitantly and one drug influences the effect of the other, leading to decreased efficacy and/or increased side effects [1,2] . DDIs can harm the patient by causing serious unwanted side effects [3] . Patients with cancer are exposed to numerous drugs, which include drugs to treat the disease, reduce associated pain, and treat comorbid illnesses (diabetes, hyperlipidemias, and cardiac diseases, etc.), along with adjuvant drugs to combat the adverse effects due to cancer chemotherapy. Exposure to multiple drugs makes these patients vulnerable to potentially serious DDIs, and it can get worse if there is a comorb

FAQs

What is the clinical concern addressed in this systematic review?

The review focuses on therapeutic DDIs that cause QT prolongation in cancer patients, which can precipitate torsades de pointes (TdP) and other adverse cardiac events.

How was the literature search conducted and what studies were included?

A thorough search was performed in databases such as PubMed, Google Scholar, and ResearchGate using MeSH terms and alternate search terms for QT prolongation, drug interactions, and cancer. Seven relevant English-language articles were included.

What prevalence of QT-prolongation–causing DDIs was reported?

Across included studies, QT prolongation–causing therapeutic DDIs occurred in 3558 of 8013 evaluated patients, with an estimated prevalence of 22% (95% CI 4%–63%).

What factors were identified as risk factors for potential DDIs?

Patient characteristics such as age, comorbid diseases, drugs used for supportive care, and polypharmacy were identified as risk factors associated with potential DDIs leading to QT interval prolongation.

Sep 23, 2026

Uploaded by Eliana