Table 5.
| Treatment | Risk of bleeding | Pharmacokinetic implications | GI implications | Hematological implications |
|---|---|---|---|---|
| Abemaciclib | No | - | X (D) | A, T |
| Abiraterone | No | - | X (D) | - |
| Afatinib | No | - | X (D) | Epistaxis |
| Alectinib | No | CYP3A4s, P-gpinh | X (D) | - |
| Anastrozole | Yes | - | X (D) | - |
| Bevacizumab | Yes | - | X (D, S) | A, T |
| Brigatinib | No | CYP3A4s, CYP3A4ind, P-gps, P-gpinh | X (D) | - |
| Cabazitaxel | Yes | - | X (D, S) | A, T |
| Capecitabine | Yes | - | X (D, S) | A |
| Carboplatin | Yes | - | D | A, T |
| Ceritinib | No | CYP3A4s, CYP3A4ind, P-gps | X (D) | A |
| Cetuximab | No | - | D, M | - |
| Cisplatin | No | - | S | A, T |
| Continuous infusion -FU | No | - | X (D, S) | A, T |
| Crizotinib | No | CYP3A4s, P-gpinh | X (D) | A |
| Cyclophosphamide | Yes | CYP3A4s | X | - |
| Dabrafenib | No | CYP3A4s, CYP3A4ind, P-gps | X (D) | A,T |
| Dacomitinib | No | P-gps | X (D) | - |
| Docetaxel | Yes | CYP3A4s | X (D, S) | A, T |
| Doxorubicin | Yes | P-gps, P-gpind, CYP3A4s | D, S | A, T |
| Entrectinib | No | CYP3A4s, P-gps | X (D) | A |
| Enzalutamine | No | CYP3A4ind | - | - |
| Epirubicin | No | - | X (D, S) | A, T |
| Eribulin | No | - | X (D, S) | A, T |
| Erlotinib | No | CYP3A4s | X (D) | Epistaxis, GI Bleeding |
| Etoposide | No | - | D, S, M | A, T |
| Exemestane | No | CYP3A4s | X (D) | T |
| Fluorouracil | No | - | X (D, S) | A, T |
| FOLFOX (Preferred) | Yes | - | D, S, M | A, T |
| Fulvestrant | Yes | - | X (D) | - |
| Gefitinib | No | CYP3A4s | X (D) | Epistaxis and haematuria |
| Gemcitabine | No | - | X (D, S) | A, T |
| Irinotecan | No | CYP3A4s | X (D) | A, T |
| Larotrectinib | No | CYP3A4s, P-gps | X | A |
| Letrozole | Yes | - | X (D) | - |
| Lorlatinib | No | CYP3A4s, P-gpinh | X (D) | A |
| Megestrol acetate | No | - | X (D) | - |
| Mitoxantrone | No | - | X (D, S) | A, T |
| Niraparib | Yes | P-gps, CYP3A4s | D, S | A, T |
| Nivolumab | No | - | D, C, S | A, T |
| Olaparib | No | CYP3A4s | D, S | A, T |
| Osimertinib (preferred) | No | - | X (D) | Platelet count decreased |
| Paclitaxel | Yes | P-gps, CYP3A4s | X (D, S) | A, T |
| Panitumumab | Yes | - | D, S | A |
| Pembrolizumab | No | - | X (D, S) | A, T |
| Radium- | No | - | X (D) | T |
| Ramucirumab | Yes | - | X (D, S) | A, T |
| Rucaparib | Yes | P-gps | D | A, T |
| Tamoxifen | Yes | CYP3A4s | X (D) | A |
| Topotecan | No | P-gps | D, M | A, T |
| Toremifene | Yes | - | X | - |
| Trametinib | Yes | P-gps | X (D) | A,T |
| Trifluridine | No | - | X (D, S) | A, T |
| Vinorelbine | No | P-gps, CYP3A4s | X (D, S) | A, T |
GI implications–X (e.g., nausea/vomiting colitis/diarrhea/mucositis); D, diarrhea; A, anemia; T, thrombocytopenia; S, stomatitis; M, mucositis substrate of CYP3A4 (CYP3A4s); inhibitor of CYP3A4 (CYP3A4inh); inducer of CYP3A4 (CYP3A4ind); P-gp inhibitor (P-gpinh); P-gp inducer (P-gpInd); P-gp substrate (P-gps). Only strong inhibitors and inducers are noted. Common or very common adverse events were included. The clinical relevance of the pharmacokinetic implications is not known