Anticancer drugs in surface waters: what can we say about the occurrence and environmental significance of cytotoxic, cytostatic and endocrine therapy drugs?

摘要: This study considers the implications and research needs arising from anticancer (also referred to as antineoplastic) drugs being released into aquatic environment, for entire therapeutic classes used: cytotoxic, cytostatic endocrine therapy drugs. A categorization approach, based on French consumption amounts, allowed highlight parent molecules several metabolites which further occurrence ecotoxicological studies should be conducted. Investigations of trends at a national local scale show an increase in use between 2004 2008, thus leading increased levels environment. It therefore appears necessary continue surveying their presence surface waters wastewater treatment plant (WWTP) effluents. Furthermore, due rise home treatments, most prescribed are now available town pharmacies. Consequently, hospital effluents no longer main expected entry route Concerning risks, current knowledge remains insufficient support definitive conclusion. Risk posed by cytotoxic is still not well documented it possible conclude long-term effects non-target organisms. To date, have been assessed using standardized or vitro assays. Such tests however may suitable drugs, work focus full-life cycle even multigenerational tests. Environmental significance (i.e. effects) cytostatics (protein kinases inhibitors monoclonal antibodies), if any, documented. Protein inhibitors, particular, deserve investigation universal mode action. Finally, concerning such antiestrogen Tamoxifen its active metabolites, could concern. Overall, accurately assess risk we discuss need break away isolated test mixtures low ng.l(-1) range.