Evaluation of clinical implementation of prospective DPYD genotyping in 5-fluorouracil- or capecitabine-treated patients. (May 2016)

• Record Type: Journal Article
• Authors: Lunenburg, Carin ATC; van Staveren, Maurice C; Gelderblom, Hans; Guchelaar, Henk-Jan; Swen, Jesse J
• Is Part Of: Pharmacogenomics. Volume 17:Number 7(2016)
• Page Start: 721
• Page End: 729
• Publication Date: 2016-05
• Subjects: capecitabine -- dihydropyrimidine dehydrogenase -- dose reductions -- DPYD -- fluoropyrimidines -- 5-fluorouracil -- implementation -- screening; Pharmacogenomics -- Periodicals; 615.1
• DOI: 10.2217/pgs-2016-0013
• Languages: English
• ISSNs: 1462-2416

Abstract

Aim: Fluoropyrimidines are commonly used anti-cancer drugs, but lead to severe toxicity in 10–30% of patients. Prospective DPYD screening identifies patients at risk for toxicity and leads to a safer treatment with fluoropyrimidines. This study evaluated the routinely application of prospective DPYD screening at the Leiden University Medical Center.Methods: Prospective DPYD screening as part of routine patient care was evaluated by retrospectively screening databases and patient files to determine genotype, treatment, dose recommendations and dose adjustments.Results: 86.9% of all patients with a first fluoropyrimidine prescription were screened. Fourteen out of 275 patients (5.1%) carried a DPYD variant and received a 25–50% dose reduction recommendation. None of the patients with a DPYD variant treated with a reduced dose developed toxicities.Conclusion: Prospective DPYD screening can be implemented successfully in a real world clinical setting, is well accepted by physicians and results in low toxicity.