Mutagenesis vol. 25 no. 4 pp. 315–326, 2010 doi:10.1093/mutage/geq025 Advance Access Publication 17 May 2010 REVIEW Genotoxic and carcinogenic effects of gastrointestinal drugs Giovanni Brambilla*, Francesca Mattioli and a further in vivo test using a tissue other than the bone marrow/ Antonietta Martelli peripheral blood should be done. Guidelines for carcinogenic- Department of Internal Medicine, Division of Clinical Pharmacology and ity testing of pharmaceuticals (4,5) indicate that a long-term Toxicology, University of Genoa, Viale Benedetto XV 2, I-16132 Genoa, Italy carcinogenicity study plus a short- or medium-term in vivo system should be performed for all pharmaceuticals whose expected clinical use is continuous for at least 6 months as *To whom correspondence should be addressed. Tel: +39 010 353 8800; well as for pharmaceuticals used frequently in an intermittent Fax: þ39 010 353 8232; Email:
[email protected] manner in the treatment of chronic recurrent conditions. In the Received on January 28, 2010; revised on March 23, 2010; absence of clear evidence favouring one species, the rat should accepted on April 13, 2010 be selected. In long-term carcinogenicity assays, the highest This review provides a compendium of retrievable results dose should be at least .25-fold, on a milligram per square of genotoxicity and carcinogenicity assays performed on meter basis, than the maximum recommended human daily marketed gastrointestinal drugs. Of the 71 drugs consid- dose or represent a 25-fold ratio of rodent to human area under ered, 38 (53.5%) do not have retrievable data, whereas the curve. The maximum tolerated dose (MTD) or a limit dose the other 33 (46.5%) have at least one genotoxicity or of 2000 mg/kg can be used as alternatives.