Key result
Prospective DPYD screening was successfully implemented in routine care, identifying 5.1% of patients with a variant, none of whom developed toxicities after receiving a recommended dose reduction.
Why the study?
Does prospective DPYD genotyping prevent toxicity in patients treated with 5-fluorouracil or capecitabine?
Observational (n=275)
No
Does prospective DPYD genotyping prevent toxicity in patients treated with 5-fluorouracil or capecitabine?
Prospective DPYD screening can be successfully implemented in routine clinical care to guide fluoropyrimidine dosing and prevent toxicity.
May support routine DPYD screening to reduce fluoropyrimidine toxicity; extends observational data but leaves open randomized confirmation.
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.
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Lunenburg et al. (2016) conducted an observational in Cancer (treated with 5-Fluorouracil or Capecitabine) (n=275). Prospective DPYD screening was evaluated on Toxicity in patients with a DPYD variant treated with a reduced dose. Prospective DPYD screening was successfully implemented in routine care, identifying 5.1% of patients with a variant, none of whom developed toxicities after receiving a recommended dose reduction.
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