Kehrer, D.F., Sparreboom, A., Verweij, J., de Bruijn, P., Nierop, C.A., van de Schraaf, J., … De Jonge, M.J. (2001). Modulation of irinotecan-induced diarrhea by cotreatment with neomycin in cancer patients. Clinical Cancer Research, 7(5), 1136–1141.
To evaluate irinotecan disposition and pharmacodynamics in the presence and absence of the broad-spectrum antibiotic neomycin
Patients experiencing grade 2 or higher diarrhea after receiving irinotecan alone (350 mg/m2 every 3 weeks) received the same dose combined with 1,000 mg oral neomycin three times per day continuously from 2 days prior to 5 days after the second course.
The study reported on 20 patients with advanced colorectal cancer receiving CPT-11 (350 mg/m2 every 3 weeks).
This was a nonrandomized trial. Patients acted as their own controls.
Presence of more than 4 stools per day and duration (measured in days) of diarrhea were recorded.
Findings indicate that bacterial B-glucorinidase plays a crucial role in irinotecan-induced diarrhea without affecting enterocycling and systemic SN-38 levels.
This was an extremely small pilot study.