Update of carcinogenicity studies in animals and humans of 535 marketed pharmaceuticals.

This survey is a compendium of information retrieved on carcinogenicity in animals and humans of 535 marketed pharmaceuticals whose expected clinical use is continuous for at least 6 months or intermittent over an extended period of time. Of the 535 drugs, 530 have the result of at least one carcinogenicity assay in animals, and 279 (52.1%) of them gave a positive response in at least one assay. Only 186 drugs (34.8%) have retrievable information on carcinogenicity in humans, and 104 of them gave to a variable extent evidence of a potential carcinogenic activity. Concerning the correlation between results obtained in animals and epidemiological findings, 58 drugs gave at least one positive result in carcinogenicity assays performed in animals and to a variable extent displayed evidence of carcinogenicity in humans, but 97 drugs tested positive in animals and were noncarcinogenic in humans or vice versa. Our findings, which are in agreement with previous studies, indicate that the evaluation of the benefit/carcinogenic risk ratio should be always made in prescribing a drug.

[1]  R. Gregson,et al.  Oxymorphone hydrochloride, a potent opioid analgesic, is not carcinogenic in rats or mice. , 2007, Toxicological sciences : an official journal of the Society of Toxicology.

[2]  A. Gough,et al.  Pancreatic acinar cell neoplasia in male Wistar rats following 2 years of gabapentin exposure. , 1995, Toxicology.

[3]  S. Shapiro,et al.  Hydralazine and breast cancer. , 1987, Journal of the National Cancer Institute.

[4]  M. Yu,et al.  Non-steroidal anti-inflammatory drugs and bladder cancer prevention , 2000, British Journal of Cancer.

[5]  A. Zuckerman,et al.  IARC Monographs on the Evaluation of Carcinogenic Risks to Humans , 1995, IARC monographs on the evaluation of carcinogenic risks to humans.

[6]  M. Shibata,et al.  Carcinogenicity of dipyrone in (C57BL/6 X C3H)F1 mice. , 1983, Journal of the National Cancer Institute.

[7]  Newberne Jw,et al.  Preclinical safety studies with terfenadine. , 1982 .

[8]  H. Milman Possible Contribution of Indomethacin to the Carcinogenicity of Nongenotoxic Bladder Carcinogens That Cause Bladder Calculi , 2007, Drug and chemical toxicology.

[9]  Y. Yoon,et al.  Preclinical toxicologic evaluation of nadolol, a new β-adrenergic antagonist☆ , 1978 .

[10]  P. Newberne,et al.  Lack of carcinogenicity of oxprenolol, a β-adrenergic blocking agent , 1977 .

[11]  M. Shoyab Enhancement by fluphenazine of dimethylbenz[a]-anthracene-induced mammary tumorigenesis in rats. , 1983, Cancer letters.

[12]  R. Hoover,et al.  Drugs in Clinical Use Which Cause Cancer , 1975 .

[13]  R. Fleischman,et al.  In vivo carcinogenesis assay of l-α-acetylmethadol·HCl in rodents , 1988 .

[14]  N. Day,et al.  Different roles for phenacetin and paracetamol in cancer of the kidney and renal pelvis , 1993, International journal of cancer.

[15]  P. Lilly,et al.  Phenolphthalein and bisacodyl: assessment of genotoxic and carcinogenic responses in heterozygous p53 (+/-) mice and syrian hamster embryo (SHE) assay. , 2006, Toxicological sciences : an official journal of the Society of Toxicology.

[16]  R. Fleischman,et al.  In vivo carcinogenesis assay of DL-methadone.HCl in rodents. , 1988, Fundamental and applied toxicology : official journal of the Society of Toxicology.

[17]  J. Huff,et al.  Toxicology and carcinogenicity studies of diuretics in F344 rats and B6C3F1 mice 2. Furosemide , 1990, Journal of applied toxicology : JAT.

[18]  Daniel F. Kripke Evidence That New Hypnotics Cause Cancer , 2008 .

[19]  R. Millikan,et al.  Association between non-steroidal anti-inflammatory drugs (NSAIDs) and invasive breast cancer and carcinoma in situ of the breast , 2003, Cancer Causes & Control.

[20]  C. D. Jackson,et al.  2-year Toxicity Study of Doxylamine Succinate in the Fischer 344 Rat , 1993 .

[21]  F. Speizer,et al.  Aspirin and lung cancer risk in a cohort study of women: dosage, duration and latency , 2007, British Journal of Cancer.

[22]  J. Becker,et al.  The carcinogenic potential of tacrolimus ointment beyond immune suppression: a hypothesis creating case report , 2006, BMC Cancer.

[23]  P. Hirsimäki,et al.  Toxicity of Antiestrogens , 2002, The breast journal.

[24]  N. Yoshimi,et al.  Carcinogenicity of chrysazin in large intestine and liver of mice. , 1986, Japanese journal of cancer research : Gann.

[25]  Carcinogenic evaluation of estazolam via diet in CD strain Sprague-Dawley rats and B6C3F1 mice for 2 years. , 1984 .

[26]  D. M. Sells,et al.  Carcinogenicity Studies with Medroxalol Hydrochloride in Rats and Mice , 1987, Toxicologic pathology.

[27]  P. Chieco,et al.  Carcinogenicity study of doxefazepam administered in the diet to Sprague-Dawley rats. , 1990, Fundamental and applied toxicology : official journal of the Society of Toxicology.

[28]  C. Niemegeers,et al.  Bezitramide (R 4845), a new potent and orally long-acting analgesic compound. , 1971, Arzneimittel-Forschung.

[29]  P. Kasper,et al.  Use of the photo-micronucleus assay in Chinese hamster V79 cells to study photochemical genotoxicity. , 2002, Mutation research.

[30]  P. Mantegazza,et al.  Pharmacological and toxicological properties of clobazam (1-phenyl-5-methyl-8-chloro-1,2,4,5-tetrahydro-2,4-diketo-3H-1,5-benzodiazepine), a new psychotherapeutic agent. , 1973, Arzneimittel-Forschung.

[31]  H. Donaubauer,et al.  Investigations on the carcinogenicity of dipyrone in rats. , 1985, Toxicology and applied pharmacology.

[32]  D. Morton,et al.  Carcinogenicity studies of fluoxetine hydrochloride in rats and mice. , 1992, Cancer research.

[33]  A. Berchuck,et al.  Antidepressant Medication Use for and Risk of Ovarian Cancer , 2005, Obstetrics and gynecology.

[34]  Y. Ohnishi,et al.  Tumor promoting potential in male F344 rats and mutagenicity in Salmonella typhimurium of dipyrone. , 1991, Carcinogenesis.

[35]  C. Bain,et al.  Aspirin, Nonsteroidal Anti-inflammatory Drugs, and the Risks of Cancers of the Esophagus , 2008, Cancer Epidemiology Biomarkers & Prevention.

[36]  L. Fishbein,et al.  A Toxicological Review of Beta-Adrenergic Blockers , 1986 .

[37]  J. Collet,et al.  Use of antidepressants and risk of colorectal cancer: a nested case-control study. , 2006, The Lancet. Oncology.

[38]  Gretchen L. Gierach,et al.  Nonsteroidal anti-inflammatory drugs and breast cancer risk in the National Institutes of Health–AARP Diet and Health Study , 2008, Breast Cancer Research.

[39]  S. Hulley,et al.  Carcinogenicity of lipid-lowering drugs. , 1996, JAMA.

[40]  I. Miyawaki,et al.  Mechanism of clobazam-induced thyroidal oncogenesis in male rats. , 2003, Toxicology letters.

[41]  H. Ury,et al.  Screening for possible drug carcinogenicity: second report of findings. , 1983, Journal of the National Cancer Institute.

[42]  T. Kälble [Etiopathology, risk factors, environmental influences and epidemiology of bladder cancer]. , 2001, Der Urologe. Ausg. A.

[43]  W. Lijinsky Induction of tumours in rats by feeding nitrosatable amines together with sodium nitrite. , 1984, Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association.

[44]  D. Rall Candidate Drugs for Carcinogenic Property Studies: Procedures , 1975 .

[45]  G R Howe,et al.  Isoniazid exposure in relation to cancer incidence and mortality in a cohort of tuberculosis patients. , 1979, International journal of epidemiology.

[46]  R. Cox,et al.  Carcinogenicity and mutagenicity studies with fluvastatin, a new, entirely synthetic HMG-CoA reductase inhibitor. , 1994, Fundamental and applied toxicology : official journal of the Society of Toxicology.

[47]  S. Heckbert,et al.  Antidepressant use and breast cancer risk , 2005, Breast Cancer Research and Treatment.

[48]  M. Rao,et al.  Inhibitory effect of antioxidants ethoxyquin and 2(3)-tert-butyl-4-hydroxyanisole on hepatic tumorigenesis in rats fed ciprofibrate, a peroxisome proliferator. , 1984, Cancer research.

[49]  P. Newberne,et al.  Effects in animals of chronic administration of spironolactone--a review. , 1978, Journal of environmental pathology and toxicology.

[50]  D. Snydman,et al.  Late incidence of cancer after metronidazole use: a matched metronidazole user/nonuser study. , 1998, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[51]  U. Goldbourt,et al.  Carcinogenicity of antihypertensive therapy , 2002, Current hypertension reports.

[52]  W. Lijinsky,et al.  Liver tumors induced in rats by oral administration of the antihistaminic methapyrilene hydrochloride. , 1980, Science.

[53]  G. Friedman,et al.  Epidemiologic evaluation of pharmaceuticals with limited evidence of carcinogenicity , 2009, International journal of cancer.

[54]  G. Williams,et al.  A critical review of the data related to the safety of quercetin and lack of evidence of in vivo toxicity, including lack of genotoxic/carcinogenic properties. , 2007, Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association.

[55]  J. Mclaughlin,et al.  International renal‐cell cancer study. II. Analgesics , 1995, International journal of cancer.

[56]  S. Prahalada,et al.  Preclinical evaluation of lovastatin. , 1988, The American journal of cardiology.

[57]  F. Horak,et al.  Comparative Tolerability of Second Generation Antihistamines , 1999, Drug safety.

[58]  K. Matsuo,et al.  Use of hydroxy‐methyl‐glutaryl coenzyme A reductase inhibitors is associated with risk of lymphoid malignancies , 2006, Cancer science.

[59]  J. Ward,et al.  Histogenesis and the role of p53 and K-ras mutations in hepatocarcinogenesis by glyceryl trinitrate (nitroglycerin) in male F344 rats. , 1996, Carcinogenesis.

[60]  K. Rieche Carcinogenicity of antineoplastic agents in man. , 1984, Cancer treatment reviews.

[61]  A. Martelli,et al.  Update on genotoxicity and carcinogenicity testing of 472 marketed pharmaceuticals. , 2009, Mutation research.

[62]  U. Vogel,et al.  Nonsteroidal anti-inflammatory drug use and breast cancer risk: a Danish cohort study , 2008, European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation.

[63]  J. Clemmesen,et al.  Epidemiological studies of medically used drugs. , 1980, Archives of toxicology. Supplement. = Archiv fur Toxikologie. Supplement.

[64]  S. Shapiro,et al.  Risk of ovarian cancer according to use of antidepressants, phenothiazines, and benzodiazepines (United States) , 2000, Cancer Causes & Control.

[65]  P. Schlattmann,et al.  Aspirin use and breast cancer risk: a meta‐analysis and meta‐regression of observational studies from 2001 to 2005 , 2008, Pharmacoepidemiology and drug safety.

[66]  Pozniak Pc The carcinogenicity of caffeine and coffee: a review. , 1985 .

[67]  B. Ryffel The carcinogenicity of ciclosporin. , 1992, Toxicology.

[68]  Chronic Toxicity/Carcinogenicity Study of Pyrilamine in B6C3F1 Mice , 1995 .

[69]  U. Mohr,et al.  The influence of caffeine on tumour incidence in Sprague-Dawley rats. , 1984, Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association.

[70]  G. Stoner,et al.  Test for carcinogenicity of food additives and chemotherapeutic agents by the pulmonary tumor response in strain A mice. , 1973, Cancer research.

[71]  M. Tamagawa,et al.  Reproduction study of carteolol hydrochloride in mice. Part 2. Peri -and postnatal toxicity. , 1979, The Journal of toxicological sciences.

[72]  M. Rossing,et al.  Analgesic drug use and risk of epithelial ovarian cancer. , 2008, American journal of epidemiology.

[73]  T Sofuni,et al.  ICH-harmonised guidances on genotoxicity testing of pharmaceuticals: evolution, reasoning and impact. , 1999, Mutation research.

[74]  W. Lijinsky Chronic toxicity tests of pyrilamine maleate and methapyrilene hydrochloride in F344 rats. , 1984, Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association.

[75]  H. Ury,et al.  Initial screening for carcinogenicity of commonly used drugs. , 1980, Journal of the National Cancer Institute.

[76]  E. Gelmann,et al.  Does tamoxifen cause cancer in humans? , 1998, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[77]  J. Shelton,et al.  Risk of breast, uterine corpus, and ovarian cancer in women receiving medroxyprogesterone injections. , 1983, Journal of the American Medical Association (JAMA).

[78]  K. Inai,et al.  Lack of Tumorigenicity of Aminopyrine Orally Administered to B6C3F1 Mice , 1990, Japanese journal of cancer research : Gann.

[79]  R. Hoover,et al.  Drug-induced cancer. , 1972, Cancer.

[80]  U. Goldbourt,et al.  Carcinogenicity of cardiovascular drugs , 1999, Current hypertension reports.

[81]  H. Watanabe,et al.  Carcinogenicity of o-ethoxybenzamide in (C57BL/6N X C3H/HeN)F1 mice. , 1986, Journal of the National Cancer Institute.

[82]  B. Ryffel,et al.  Toxicological evaluation of cyclosporin A , 1983, Archives of Toxicology.

[83]  H. Sternbach Are antidepressants carcinogenic? A review of preclinical and clinical studies. , 2003, The Journal of clinical psychiatry.

[84]  M. Cotterchio,et al.  Do antidepressants cause, promote, or inhibit cancers? , 1995, Journal of clinical epidemiology.

[85]  M. Enomoto,et al.  Toxicological aspects of feprazone, a new nonsteroidal anti-inflammatory drug. , 1982, Toxicology and applied pharmacology.

[86]  M. Yu,et al.  Regular use of analgesics is a risk factor for renal cell carcinoma , 1999, British Journal of Cancer.

[87]  G. Pohlmeyer-Esch,et al.  Evaluation of chronic oral toxicity and carcinogenic potential of lornoxicam in rats. , 1997, Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association.

[88]  S. Shapiro,et al.  Hydralazine use in relation to cancers of the lung, colon, and rectum , 2004, European Journal of Clinical Pharmacology.

[89]  P. Wutzler,et al.  Genetic risks of antiviral nucleoside analogues--a survey. , 2001, Antiviral research.

[90]  G. Eisenbrand,et al.  Carcinogenicity of methapyrilene hydrochloride, mepyramine hydrochloride, thenyldiamine hydrochloride, and pyribenzamine hydrochloride in Sprague-Dawley rats , 2004, Journal of Cancer Research and Clinical Oncology.

[91]  W. A. Kelly,et al.  Tumorigenicity Assays of Sotalol Hydrochloride in Rats and Mice , 1979, Journal of clinical pharmacology.

[92]  G. Friedman Barbiturates and lung cancer in humans. , 1981, Journal of the National Cancer Institute.

[93]  J. Olsen,et al.  Statin Use and Cancer Risk: An Epidemiologic Review , 2006, Cancer investigation.

[94]  J. Haseman,et al.  Carcinogenicity studies of oxazepam in mice. , 1994, Fundamental and applied toxicology : official journal of the Society of Toxicology.

[95]  Kyoko Watanabe,et al.  Carcinogenic susceptibility of rasH2 mice to troglitazone , 2007, Archives of Toxicology.

[96]  P. Coogan Review of the epidemiological literature on antidepressant use and breast cancer risk , 2006, Expert review of neurotherapeutics.

[97]  J. Guitart,et al.  Hydroxyurea-associated squamous dysplasia. , 2004, Journal of the American Academy of Dermatology.

[98]  J. Huff,et al.  Toxicology and carcinogenicity studies of diuretics in F344 rats and B6C3F1 mice 1. Hydrochlorothiazide , 1990, Journal of applied toxicology : JAT.

[99]  J W Green,et al.  A review of the genotoxicity of marketed pharmaceuticals. , 2001, Mutation research.

[100]  Carcinogenicity studies of astemizole in mice and rats. , 1995, Cancer research.

[101]  M. Greene,et al.  Is cisplatin a human carcinogen? , 1992, Journal of the National Cancer Institute.

[102]  W. Allaben,et al.  Triprolidine: 104-Week Feeding Study in Rats , 1995, Fundamental and applied toxicology : official journal of the Society of Toxicology.

[103]  K. Clausen,et al.  Carcinoma of the urinary bladder in patients receiving cyclophosphamide. , 1975, The New England journal of medicine.

[104]  D. Streiner,et al.  Antidepressants and the Risk of Breast Cancer , 2002, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[105]  A. Monro,et al.  A carcinogenicity study in mice of a beta-adrenergic antagonist, primidolol; increased total tumour incidence without tissue specificity. , 1981, Toxicology.

[106]  S Nesnow,et al.  Chemical carcinogens. A review and analysis of the literature of selected chemicals and the establishment of the Gene-Tox Carcinogen Data Base. A report of the U.S. Environmental Protection Agency Gene-Tox Program. , 1987, Mutation research.

[107]  G. Carr,et al.  Prednisone is Not a Mouse Carcinogen , 1992, Toxicologic pathology.

[108]  L. Bernstein,et al.  Nonsteroidal Anti-inflammatory Drugs and Risk of Esophageal and Gastric Adenocarcinomas in Los Angeles County , 2008, Cancer Epidemiology Biomarkers & Prevention.

[109]  R J Szot,et al.  Preclinical safety evaluation of the benzodiazepine quazepam. , 1987, Arzneimittel-Forschung.

[110]  E. McGuire,et al.  Chronic toxicity and carcinogenicity studies with the beta-adrenoceptor antagonist levobunolol. , 1992, Fundamental and applied toxicology : official journal of the Society of Toxicology.

[111]  M. Cotterchio,et al.  Use of Antidepressant Medications and the Possible Association with Breast Cancer Risk , 2003, Psychotherapy and Psychosomatics.

[112]  H Friehe,et al.  Pharmacological and toxicological studies of the new angiotensin converting enzyme inhibitor moexipril hydrochloride. , 1997, Arzneimittel-Forschung.

[113]  A. Whittemore,et al.  Short-Term Chloral Hydrate Administration and Cancer in Humans , 2006, Drug Safety.

[114]  G. Steineck,et al.  Acetaminophen, some other drugs, some diseases and the risk of transitional cell carcinoma. A population-based case-control study. , 1995, Acta oncologica.

[115]  W. Sheldon,et al.  Two-Year Toxicity Study of Doxylamine Succinate in B6C3F1 Mice , 1993 .

[116]  L. G. García Rodríguez,et al.  Breast Cancer Risk Among Users of Antidepressant Medications , 2005, Epidemiology.

[117]  G. Steineck,et al.  Epidemiology and Etiology of Premalignant and Malignant Urothelial Changes , 2000, Scandinavian journal of urology and nephrology. Supplementum.

[118]  D. Cramer,et al.  Self-reported use of antidepressants or benzodiazepine tranquilizers and risk of epithelial ovarian cancer: evidence from two combined case-control studies (Massachusetts, United States) , 1995, Cancer Causes & Control.

[119]  B. Strom,et al.  Lung cancer and regular use of aspirin and nonaspirin nonsteroidal anti‐inflammatory drugs , 2008, Pharmacoepidemiology and drug safety.

[120]  E. Negri,et al.  Coffee consumption and risk of non‐Hodgkin's lymphoma , 1994, European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation.

[121]  R. Stephens,et al.  An assessment of the carcinogenicity of isoniazid in patients with pulmonary tuberculosis. , 1976, Tubercle.

[122]  J. Ward,et al.  Lack of promoting effect of clonazepam on the development of N-nitrosodiethylamine-initiated hepatocellular tumors in mice is correlated with its inability to inhibit cell-to-cell communication in mouse hepatocytes. , 1989, Carcinogenesis.

[123]  R. Bagdon,et al.  Chronic Toxicity/Carcinogenesis Study of Temazepam in Mice and Rats , 1984 .

[124]  R. Hoover,et al.  Drug‐induced cancer , 1981, Journal of the National Cancer Institute.

[125]  Berg Kj [Paracetamol--kidney and urinary tract. A cause of analgetic nephropathy or cancer?]. , 1994 .

[126]  J. P. Gibson,et al.  Induction of Uterine Leiomyomas in Mice by Medroxalol and Prevention by Propranolol , 1987, Toxicologic pathology.

[127]  H. Bartsch,et al.  Characterization and identification of 6 mutagens in opium pyrolysates implicated in oesophagel cancer in Iran , 1985 .

[128]  R. Snyder A review and investigation into the mechanistic basis of the genotoxicity of antihistamines. , 1998, Mutation research.

[129]  J. Meyerhardt,et al.  Aspirin dose and duration of use and risk of colorectal cancer in men. , 2008, Gastroenterology.

[130]  A. Walker,et al.  Statin use, hyperlipidaemia, and the risk of breast cancer , 2002, British Journal of Cancer.

[131]  S. Hankinson,et al.  Aspirin, NSAID, and acetaminophen use and the risk of endometrial cancer. , 2008, Cancer research.

[132]  J. Haseman,et al.  Toxicity and carcinogenicity studies of oxazepam in the Fischer 344 rat. , 1998, Toxicological sciences : an official journal of the Society of Toxicology.

[133]  E. McGuire,et al.  Carcinogenicity studies in rodents and ripazepam, a minor tranquilizing agent. , 1984, Fundamental and applied toxicology : official journal of the Society of Toxicology.

[134]  J. Fraumeni,et al.  Aspirin Use and Risk of Biliary Tract Cancer: A Population-Based Study in Shanghai, China , 2005, Cancer Epidemiology Biomarkers & Prevention.

[135]  A. Bendesky,et al.  Is metronidazole carcinogenic? , 2002, Mutation research.

[136]  E. McGuire,et al.  Calcium valproate-induced uterine adenocarcinomas in Wistar rats. , 1992, Toxicology.

[137]  W. Lijinsky,et al.  Pathologic Effects of Chronic Administration of Hydrochlorothiazide, with and without Sodium Nitrite, to F344 Rats , 1987, Toxicology and industrial health.

[138]  S. Heckbert,et al.  The association between 3‐hydroxy‐3‐methylglutaryl conenzyme A inhibitor use and breast carcinoma risk among postmenopausal women , 2004, Cancer.