Revisión bibliográfica narrativa sobre la interacción fármaco-nutriente y su impacto clínico en pacientes con cáncer colorrectal bajo terapia antineoplásica: implicaciones para la optimización de la atención farmacéutica

Abstract

Abstract: Colon cancer is a leading cause of morbidity and mortality worldwide, and its pharmacological treatment is primarily based on antineoplastic agents such as 5-FU, oxaliplatin, and irinotecan, which can be influenced by patients' nutrition and nutrient intake. This narrative review aims to analyze, identify, and systematize the evidence on drug-nutrient interactions in colorectal cancer patients undergoing antineoplastic therapy; furthermore, it seeks to establish the implications of nutrient use for optimizing pharmaceutical care by analyzing its effects on therapeutic efficacy. The research was conducted through a narrative literature review of scientific literature in databases (PubMed, Scopus, etc.). Studies published between 2016 and 2026 were analyzed, including 28 studies with varied designs: 10 narrative reviews, 6 observational studies, 5 systematic reviews, 4 experimental clinical trials, 1 case report, 1 preclinical study, and 1 retrospective survey. This allowed the topic to be addressed from multiple levels of scientific evidence. The results showed that polyphenol compounds potentiate the antitumor effect of drugs such as 5-fluorouracil, oxaliplatin, irinotecan, and regorafenib. In contrast, St. John's wort, an antagonist that induces CYP3A4 and P-gp, reduces the efficacy of irinotecan. Furthermore, the consumption of milk or eggs in patients treated with capecitabine is associated with increased hematological toxicity. In conclusion, the evidence is heterogeneous and predominantly clinical or observational. Some interactions have established clinical relevance, while others require confirmation; further clinical research is needed to establish broader nutritional recommendations based on scientific evidence.