Strategies for DPYD testing prior to fluoropyrimidine chemotherapy in the US.

Autor: Tracksdorf T; Deparment of Clinical Pharmacy, University of Michigan College of Pharmacy, 428 Church St, Room 2560C, Ann Arbor, MI, 48109-1065, USA., Smith DM; Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.; MedStar Health, Columbia, MD, USA., Pearse S; Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA., Cicali EJ; Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, USA.; Center for Pharmacogenomics and Precision Medicine, University of Florida, Gainesville, FL, USA., Aquilante CL; Department of Pharmaceutical Sciences, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.; Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA., Scott SA; Department of Pathology, Stanford University, Stanford, CA, USA.; Clinical Genomics Laboratory, Stanford Medicine, Palo Alto, CA, USA., Ho TT; Department of Pathology, Moffitt Cancer Center, Tampa, FL, USA., Patel JN; Department of Cancer Pharmacology and Pharmacogenomics, Atrium Health Levine Cancer Institute, Charlotte, NC, USA.; Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, USA., Hicks JK; Department of Pathology, Moffitt Cancer Center, Tampa, FL, USA., Hertz DL; Deparment of Clinical Pharmacy, University of Michigan College of Pharmacy, 428 Church St, Room 2560C, Ann Arbor, MI, 48109-1065, USA. DLHertz@med.umich.edu.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2024 Jul 09; Vol. 32 (8), pp. 497. Date of Electronic Publication: 2024 Jul 09.
DOI: 10.1007/s00520-024-08674-1
Abstrakt: Purpose: Patients with dihydropyrimidine dehydrogenase (DPD) deficiency are at high risk for severe and fatal toxicity from fluoropyrimidine (FP) chemotherapy. Pre-treatment DPYD testing is standard of care in many countries, but not the United States (US). This survey assessed pre-treatment DPYD testing approaches in the US to identify best practices for broader adoption.
Methods: From August to October 2023, a 22-item Qualtrics XM survey was sent to institutions and clinicians known to conduct pre-treatment DPYD testing and broadly distributed through relevant organizations and social networks. Responses were analyzed using descriptive analysis.
Results: Responses from 24 unique US sites that have implemented pre-treatment DPYD testing or have a detailed implementation plan in place were analyzed. Only 33% of sites ordered DPYD testing for all FP-treated patients; at the remaining sites, patients were tested depending on disease characteristics or clinician preference. Almost 50% of sites depend on individual clinicians to remember to order testing without the assistance of electronic alerts or workflow reminders. DPYD testing was most often conducted by commercial laboratories that tested for at least the four or five DPYD variants considered clinically actionable. Approximately 90% of sites reported receiving results within 10 days of ordering.
Conclusion: Implementing DPYD testing into routine clinical practice is feasible and requires a coordinated effort among the healthcare team. These results will be used to develop best practices for the clinical adoption of DPYD testing to prevent severe and fatal toxicity in cancer patients receiving FP chemotherapy.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: