Page 225 - Personalised medicine of fluoropyrimidines using DPYD pharmacogenetics Carin Lunenburg

Evaluating the implementation of prospective DPYD genotyping
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Table 4. DPYD variant carrying patients
Listed for LUMC patients who carry a DPYD variant are genotyping data, therapy details and toxicity data.
pt# Cancer Therapy DPYD
Pro- spective screen- ing?
Initial dose adjust- ment?a
Toxicity Toxicity Hospital Second dose (grade specifications admissions? adjustment? 3–4)?
Toxicity Toxicity Hospital (grade specifica- admissions? 3–4)? tions
type
variant
1 Colo- rectal
CAPOX TPF + RT
c.1236G>A c.1236G>A
YES NOb
YES NO
NO YES
N/A
N/A
YES (to 100%)
NO N/A N/A N/A
N/A N/A
2 Mouth
Diarrhoea IV + Neutropenia/ Thrombocyto- penia III
YES (6+16 days)
N/A (Quit af- ter 2nd cycle)
3 Colon (met.)
CAPOX + BEV
c.1236G>A c.1236G>A c.1236G>A c.1236G>A c.1236G>A DPYD*2A
YES
YES
YES
YES
YES
YES
YES YES DNSc YES YES YES
NO NO N/A NO NO NO
N/A N/A N/A N/A N/A N/A
N/A N/A N/A N/A N/A N/A
NO
NO
N/A
NO
N/A (Quit) YES (to ±80%)
N/A N/A
N/A N/A
N/A N/A
N/A N/A
N/A N/A
YES Diarrhoea
N/A
N/A
N/A
N/A
N/A
YES (31 days)
4 Anus
5 Colon
6 Pharynx
7 Pancreas
8 Rectal
5-FU + RT
9 Mamma (met.)
CAPOX CAPOX
DPYD*2A + c.2846A>T
YES YES
No dose recomm.d
NO NO
N/A N/A
N/A N/A
N/A (Quit) YES (to 100%)
N/A N/A
N/A
10 Mamma (met.)
DPYD*2A
YES
YES HFS II–III (not
in first
cycles)
NO (switch to Paxclitaxel, after 8 cycles)
N/A
5-FU + RT
CAP
CAP + RT
III + Enteritis
table continues