A Different Kind of Relapse: Ethanol as an Additive in Chemotherapy Formulations

Some chemotherapy formulations contain ethanol as a solvent which can become relevant for medical and nonmedical reasons. Only a few studies have tried to quantify the effects of ethanol in chemotherapy preparations. Furthermore, the alcohol amount highly depends on the specific formulation, with some variation among different manufacturers. Although the actual increase in blood alcohol levels after ethanol-based chemotherapies seems to be limited, the FDA recently released a warning that docetaxel may cause symptoms of alcohol intoxication. Here, we report on a patient with breast cancer who experienced a relapse of alcohol abuse after a single docetaxel infusion. We hypothesize a causal relationship with the ethanol-containing docetaxel infusion. Today, no guidelines exist for the use of ethanol-based chemotherapy, and patient consent forms do not address this matter. We conclude that physicians prescribing chemotherapy and patients should be aware of the potential risks of ethanol-containing infusions and nonethanol-based alternatives should be discussed when needed or desired by the patient. This could be facilitated by revised patient consent forms.