Page 216 - Personalised medicine of fluoropyrimidines using DPYD pharmacogenetics Carin Lunenburg
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Chapter 8
Abstract
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.
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.
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.
Prospective DPYD screening can be implemented successfully in a real world clinical setting, is well accepted by physicians and results in low toxicity.
Acknowledgements
All medical oncologists and fellows working at the LUMC department of Medical Oncology during the observation period of the study are kindly thanked.
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