Antineoplastic compounds in the environment-substances of special concern

Area of Science:

• Environmental chemistry
• Pharmacology
• Ecotoxicology

Background:

• Antineoplastic drugs are crucial for cancer therapy but pose environmental risks due to excretion into wastewater.
• Their presence in aquatic environments, even at low concentrations, warrants careful risk assessment.
• Existing guidelines may not adequately address the risks of DNA-damaging antineoplastics.

Purpose of the Study:

• To evaluate the potential underestimation of risks from antineoplastic drugs in the aquatic environment.
• To assess the relevance of current European Medicines Agency (EMA) and FDA guidelines for these pharmaceuticals.
• To highlight the increasing prevalence of DNA-damaging antineoplastic agents.

Main Methods:

• Identification of 102 environmentally relevant antineoplastic agents (ATC group L01).
• Analysis of consumption data in Germany (20.7 t in 2012).
• Assessment of the increasing proportion of DNA-damaging drugs over six years.

Main Results:

• The share of DNA-damaging antineoplastics increased from 24% to 67% in six years.
• Capecitabine and 5-fluorouracil constituted 39% of total consumption (8 t).
• Approximately 80% of consumed antineoplastics are excreted at home.

Conclusions:

• A case-by-case risk evaluation is recommended based on the mode of action of antineoplastic drugs.
• DNA-damaging antineoplastic agents require independent assessment, as generic action limits may be insufficient.
• Further research is needed to fully understand and mitigate the ecotoxicological impact of these drugs.