# Is Micronucleus Assay a Suitable Biomarker for Evaluating the Cancer Risk in Professionals Exposed to Antineoplastic Drugs? A Systematic Review

## TL;DR

This paper reviews whether the micronucleus assay can be used to assess cancer risk in healthcare workers exposed to anticancer drugs.

## Contribution

It systematically evaluates the reliability of the micronucleus assay as a biomarker for genotoxic effects in professionals handling antineoplastic drugs.

## Key findings

- 23 out of 28 studies observed genotoxic effects linked to anticancer drugs.
- The micronucleus assay is suggested as a suitable biomonitoring tool for assessing cancer risk in exposed professionals.
- Most studies were of high quality, supporting the reliability of the findings.

## Abstract

The widespread use of antineoplastic drugs in cancer treatment has led to significant concerns regarding the potential health risks posed to healthcare professionals involved in the preparation, administration, and handling of these chemical compounds, including genotoxicity. This systematic review investigates the genotoxicity of various anticancer drugs through the micronucleus assay in mammalian cells through a comprehensive analysis of studies retrieved from PubMed, SCOPUS, and Web of Science. A systematic search conducted in May 2025 identified 28 relevant studies, all of which employed the micronucleus assay. The results indicated that 23 of the reviewed studies observed genotoxic effects linked to several drugs. As for the quality assessment, all studies (but one) were categorized as either strong or moderate; therefore, we consider our findings to be reliable. These findings raise significant concerns regarding the potential health risks associated with oncologic drugs, warranting further investigation and regulatory oversight to ensure professionals' safety. Finally, such findings are very important for clarifying the role of the micronucleus assay as a putative biomarker for evaluating the cancer risk due to anticancer drug exposure in humans.

Health professionals who are continuously exposed to antineoplastic drugs are at increased risk for cancer due to an increased incidence of micronuclei in lymphocytes and oral cells. Additionally, the micronucleus assay is an appropriate biomonitoring tool for these professionals.