Near Miss or Standard of Care? DPYD Screening for Cancer Patients Receiving Fluorouracil
| Title: | Near Miss or Standard of Care? DPYD Screening for Cancer Patients Receiving Fluorouracil |
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| Authors: | Lauren E. Winquist, Michael Sanatani, Richard B. Kim, Eric Winquist |
| Source: | Current Oncology, Vol 28, Iss 1, Pp 94-97 (2020) |
| Publisher Information: | MDPI AG, 2020. |
| Publication Year: | 2020 |
| Collection: | LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens |
| Subject Terms: | fluoropyrimidines, dihydropyrimidine dehydrogenase, cancer, adverse effects, single nucleotide polymorphisms, drug therapy, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| More Details: | 5-fluorouracil (5-FU) and its pro-drug capecitabine are widely used anticancer agents. Most 5-FU catabolism is dependent on dihydropyrimidine dehydrogenase (DPD) encoded by the DPYD gene, and DPYD variants that reduce DPD function increase 5-FU toxicity. Most DPD deficient patients are heterozygous and can be treated with reduced 5-FU dosing. We describe a patient with a genotype associated with near complete absence of DPD function, and severe and likely fatal toxicity with 5-FU treatment. The patient was treated effectively with alternative systemic therapy. Routine pretreatment DPYD genotyping is recommended by the European Medicines Agency, and guidelines for use of 5-FU in DPD deficient patients are available. However, outside the province of Quebec, routine pretreatment screening for DPD deficiency remains unavailable in Canada. It is likely our patient would have died from 5-FU toxicity under the current standard of care, but instead provides an example of the potential benefit of DPYD screening on patient outcomes. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 1718-7729 1198-0052 |
| Relation: | https://www.mdpi.com/1718-7729/28/1/12; https://doaj.org/toc/1198-0052; https://doaj.org/toc/1718-7729 |
| DOI: | 10.3390/curroncol28010012 |
| Access URL: | https://doaj.org/article/db5c8ef7aed54c7993b28271286dccba |
| Accession Number: | edsdoj.b5c8ef7aed54c7993b28271286dccba |
| Database: | Directory of Open Access Journals |
| ISSN: | 17187729 11980052 |
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| DOI: | 10.3390/curroncol28010012 |
| Published in: | Current Oncology |
| Language: | English |