Development of a rapid risk evaluation tool for herbs/drugs interactions in cancer patients: a multicentric experience in south of France.

Cancer patients use herbs in spite of severe interactions risks with major anticancer drugs. In daily practice, it is very difficult for oncologists to detect and define the risk of a herb-anticancer drug interaction (HDI). In this work, we realised a state of play in one of the most populated region of France by evaluating, through a specific questionnaire, the position of a representative panel of oncologists. About 80% of them thought that herbs interact with anticancer treatments whereas only 15.4% of them actually knew the real HDI. About 89.1% of them thought that a practical detection tool would be relevant and useful for their daily practice. Then, we constructed a tool in order to rapidly evaluate a HDI risk level. Based on experts' reviews and using a criticality matrix, we determined the HDI risk level between 11 herbs and 126 anticancer drugs. Then, we measured satisfactory of oncologists. All of them considered the tool as useful in their daily practice and then used it. This work highlighted that even if HDI has been integrated as a theoretical risk, its practical detection and risk evaluation is difficult to implement for oncologists in their daily practice. Thus, the tool we developed should answer to an unmet medical need.