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Old 02-15-2012, 01:18 PM   #5
gdpawel
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Re: Fasting to enhance chemo

This is one of several similar findings. An editorial in the Journal of Clinical Oncology by University of Chicago researchers that ruffled some industry feathers by arguing that taking Tykerb with fatty meals (the label says not to) is synergistic, greatly improved absorption and could lead to reduced doses (by 60%) which means less cost for the $2,900-a-month price tag, and reduced side effects, particularly diarrhea.

A company-sponsored study showed that Tykerb blood levels increased by 167% when taken with a low-fat meal, compared with taking the drug on an empty stomach -- and by 325% after a high-fat meal. Researchers, Drs. Mark Ratain and Ezra Cohen, argue that these kinds of food-drug interactions should be explored to lower drug costs.

And if taken with grapefruit juice, the potential cost savings could be about 80%, since Tykerb interacts with CYP3A4. Powerful compounds in the grapefruit called furanocoumarins obliterate the CYP3A4 enzyme in the intestines and liver. The result is that more of the drug gets into the bloodstream.

Individuals have different levels of CYP3A4 that breaks down drugs before they even have the chance to get into the bloodstream. Patients with very active CYP3A4 get lower amounts of drugs into their systems than those with low levels of the enzyme. Some patients may have naturally low levels of the CYP3A4 enzyme and thus wouldn't need it,

Certain drugs have a hard time reaching optimal blood levels at prescribed doses. Some doctors are interested in intentionally boosting the effects with grapefruit.

http://jco.ascopubs.org/content/25/23/3397.full.pdf

In addition to Tykberb, Zytiga (abiraterone) is also better absorbed with food, though (it too) the label says empty stomach. Cell function analysis has been able to reverse Zytiga resistance by having patients take it with a fatty meal.
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