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The caffeine-chemotherapy connection.

The Caffeine-Chemotherapy connection

In the attack on cancer, physicians must estimate the highest chemotherapy doses their patients can tolerate without life-threatening side effects. Oncologists using the experimental cancer drug amonafide face a particularly precarious balancing act, because different people metabolize the drug in different ways. While some can take the "standard" amonafide regimen with no problems, others develop potentially lethal infections as their bodies convert the drug into large amounts of a toxic metabolite that damages the immune system.

Noting that the body metabolizes amonafide and caffeine similarly, Mark J. Ratain and his colleagues at the University of Chicago devised a caffeine test designed to predict a person's risk of amonafide toxicity.

The team studied 18 people with colon breast or other types of cancer. They instructed the volunteers to drink a cup of caffeine-containing coffee or cola and to collect urine samples four to six hours later. In analyzing the samples, they discovered that seven people metabolized caffeine in a way that suggested a predisposition to amonafide toxicity. Later, when each of the 18 participants received a standard dose of amonafide, signs of drug-related toxicity emeged in the same seven people, including three who responded with a severe decline in white blood cells, Ratain says.

Among the remaining 11 participants -- whose caffeine tests had suggested a low risk of drug-related toxicity -- seven showed no significant toxicity from the amonafide dose.

People whose caffeine tests indicate low risk should receive larer-tahn-average amonafide doses for a more potent blast against cancer cells, Ratain suggest, while those who appear vulnerable to amonafide toxicity should receive less than the standard dose or switch to another treatment.

Ultimately, he notes, the test's value will depend on whether amonafide -- which is showing some antitumor promise in U.S. clinical trials -- proves an effective cancer-fighter.
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Title Annotation:using caffeine to predict a person's risk of toxicity to amonafide, to determine the proper dose
Author:Fackelmann, Kathy A.
Publication:Science News
Date:Apr 6, 1991
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