Biological monitoring screening of patients provided antineoplastic drugs including adriamycin, cyclophosphamide, 5-fluorouracil, methotrexate, and vincristine.
Screening biomarkers of exposure to antineoplastic drugs were established. The anticancer drugs that were administered to 11 patients undergoing cancer chemotherapy included cyclophosphamide, adriamycin, methotrexate, vincristine, 5-fluorouracil, megestrol- acetate, and/or procarbazine. The urinary parameters that were assessed included thioethers, D-glucaric-acid, elements, and forward and reverse mutagenesis using bacterial bioassays. Data were analyzed in terms of concentrations observed and corrected for personal baseline. Personal baseline correction for the parameters with significant nonexposure baseline levels proved essential. Glucaric-acid was influenced by methotrexate and vincristine. Thioether content was affected by cyclophosphamide. The forward mutagenesis assay was directly correlated to cyclophosphamide dose, but the reverse assay was not. Elements affected by the anticancer drugs relative to controls included potassium, sulfur, phosphorus, calcium, magnesium, sodium, and/or carbon. The authors conclude that the forward mutagenesis assay and D-glucaric-acid concentrations were the best screening biomarkers for monitoring exposure to antineoplastic drugs.