Download Pill against lung cancer more easily absorbed with a coke

Pill against lung cancer more easily absorbed with a coke
It has been found that the absorption of the lung cancer drug erlotinib (Tarceva) into the blood stream
increases if the tablet is taken with a glass of coke.
The problem is that many cancer patients take stomach protectors against the adverse effects of their
strong medication (such as the increased risk of stomach bleeding).
But the stomach protectors make the stomach less acidic, which results in the cancer drugs being
absorbed less well into the bloodstream.
So the search was on for a method to make the stomach more acidic for a short period of time, so that
the drug could be absorbed, while the patient could continue taking the stomach protectors (thereby
remaining protected) without adverse side-effects.
A glass of regular coke (not diet coke) temporarily makes the stomach more acidic and increases the
absorption into the bloodstream of the drug by an average of 40 percent when the patient takes
erlotinib with a stomach protector.
How many people participated in the study?
We required 28 evaluable lung cancer patients for this study.
How did we conduct the study?
The group of patients took the anti-cancer drug with water one week, and the next week they took the
tablets with coke (250 ml). They first took a few sips of coke, as if creating a puddle in the stomach, and
then they took another sip to swallow the tablet. Finally, they drank the remaining coke. This
temporarily made the stomach very acidic so that the tablet dissolved easily and was absorbed quickly
into the bloodstream.
Some patients showed an increased absorption of more than 100 percent. Does this mean that too
much medication is absorbed into the bloodstream?
Higher doses of erlotinib are generally also well tolerated. We did not see more side-effects in the group
who took erlotinib with coke in the study.
Did Coca-Cola subsidize the study?
No, Coca-Cola did not provide funds for the study. Nor were they involved in the design of the study.
Can the same effect be achieved with other acidic beverages, such as orange juice?
Orange juice tastes sour, but the pH value * is higher than in coke. There are other beverages that are
acidic, such as tonic, but a glass of regular coke is by far the most acidic. In other words: not diet coke or
coke zero. The brand used is unlikely to make a difference. We did not include ice tea in the study. *the
acidity is measured based on the pH value: pH1 is a strong acid (very sour), pH 10 is alkaline and
therefore the opposite of sour. pH 7 is neutral.
Isn’t coke really bad for you?
Coke contains large amounts of sugar and is therefore not particularly healthy, but the quantities used
in the study are small. Small, 0.25l cans were used. Furthermore, in our opinion the potential benefits
achievable in fighting cancer outweigh the possible drawbacks of drinking coke.
Only last week a Japanese researcher reported that soft drinks could be bad for your heart. How does
this relate to this study?
We are not claiming that coke is healthy, but it is apparently not all bad.
Does it also work with chemotherapy?
We saw no evidence for this as chemotherapy is usually administered intravenously and the effect of
drinking coke in this study is linked to the fact that the innovative anti-cancer drug is in tablet form.
For what other drugs could coke work?
We believe that it may work for the new generation cancer drugs (the so-called tyrosine kinase
inhibitors) and other tablets that are dependent on gastric acidity for solubility.
Why can you not yet say that the pills work better with coke?
Initially, only the amount of active substances absorbed into the bloodstream was examined. Although it
is expected that this also says something about the degree of efficacy, further research is needed to
prove this.
This seems like such a simple solution to a major problem. Why only now?
Until recently, anti-cancer drugs were mainly administered intravenously, rather than in tablet form.
Perhaps it is because only now are such practical solutions being sought and found.
Is coke more harmful to people who are already sick?
There is no evidence for this. Of course, extra care must be taken with diabetes patients.
Where do we go from here?
The results presented at the ECC conference must first be published. Then guidelines committees will
review the findings and decide whether coke should be included in the treatment with erlotinib.
Can patients using erlotinib already start taking this medication with coke?
No, certainly not. We always advise patients to consult their treating physician first. Taking the tablets
with coke can have specific effects for individual patients.
Are there other foods/beverages that have an effect on anti-cancer treatments?
Other acidic beverages are also likely to have an effect on the absorption of erlotinib. However, coke is
one of the most acidic beverages available in stores. Therefore, in theory, this will have the greatest
effect.
Why do many people receiving anti-cancer treatment take antacids?
Medication prescribed to cancer patients is often very hard on the stomach. Taking blood thinners
without stomach protectors could even result in gastrointestinal bleeding. Antacids are therefore
indispensable drugs in treating cancer patients.
Does coke reduce the effect of the antacids?
No, this is absorbed into the bloodstream as always. Moreover, coke doesn’t stay in the stomach very
long so the antacids can do their job as normal once the coke is gone.
How many people being treated with tyrosine kinase inhibitors also take antacids?
We are not exactly sure, but we estimate about half the patients.
Does drinking coke also have an effect on the treatment if you do not take antacids?
Yes, but far less than if the pH in the stomach is increased by an antacid. The stomach of most people is
already more acid without antacids than with antacids, so, logically, the effect of coke is then reduced.