Near Miss or Standard of Care? DPYD Screening for Cancer Patients Receiving Fluorouracil
| Autor: | Lauren E Winquist, Eric Winquist, Richard B. Kim, Michael Sanatani |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Oncology
medicine.medical_specialty Antimetabolites Antineoplastic Near Miss Healthcare Case Report fluoropyrimidines 030226 pharmacology & pharmacy Capecitabine 03 medical and health sciences single nucleotide polymorphisms 0302 clinical medicine Pharmacotherapy Internal medicine Neoplasms medicine Dihydropyrimidine dehydrogenase Humans cancer Dosing Adverse effect Dihydrouracil Dehydrogenase (NADP) Early Detection of Cancer RC254-282 Cancer business.industry Adverse effects dihydropyrimidine dehydrogenase Fluoropyrimidines Neoplasms. Tumors. Oncology. Including cancer and carcinogens Standard of Care Single nucleotide polymorphisms medicine.disease drug therapy Fluorouracil 030220 oncology & carcinogenesis adverse effects DPYD Drug therapy business medicine.drug |
| Zdroj: | Current Oncology, Vol 28, Iss 12, Pp 94-97 (2021) Paediatrics Publications Current Oncology |
| ISSN: | 1198-0052 1718-7729 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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