Page 71 - Personalised medicine of fluoropyrimidines using DPYD pharmacogenetics Carin Lunenburg

DPWG guideline for DPYD and fluoropyrimidines
between 5-FU/capecitabine and tegafur within the therapeutic recommendations for fluoropyrimidines, where the CPIC guideline does not provide any dosing recommendations for tegafur due to the limited available evidence. DPWG also further distinguishes between systemic and cutaneous routes of administration within the 5-FU/capecitabine recommendations. The therapeutic recommendations for 5-FU/capecitabine also differ regarding the following: 1) For patients with gene activity score 0: DPWG recommends phenotyping while CPIC does not when no alternative is available. 2) For patients with gene activity score 0.5: DPWG recommends initiating therapy with 25% of standard dose or an alternative whereas CPIC recommends an alternative or a strongly reduced dose with therapeutic drug monitoring, but does not provide an absolute percentage. 3) For patients with gene activity score 1.5 the DPWG recommends a 75% standard dose whereas CPIC recommends a 50% of standard dose.
4
69