DPYD genotyping and dihydropyrimidine dehydrogenase (DPD) phenotyping in clinical oncology. A clinically focused minireview

Niels Herluf Paulsen*, Fie Vojdeman, Stig Ejdrup Andersen, Troels K Bergmann, Marianne Ewertz, Peter Plomgaard, Morten Rix Hansen, Peter Skov Esbech, Per Pfeiffer, Camilla Qvortrup, Per Damkier

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftReviewForskningpeer review

Abstract

BACKGROUND: In clinical oncology, systemic 5-fluorouracil (5-FU) and its oral pro-drugs are used to treat a broad group of solid tumours. Patients with dihydropyrimidine dehydrogenase (DPD) enzyme deficiency are at elevated risk of toxicity if treated with standard doses of 5-FU. DPYD genotyping and measurements of plasma uracil concentration (DPD phenotyping) can be applied as tests for DPD deficiency. In April 2020, the European Medicines Agency recommended pre-treatment DPD testing to reduce the risk of 5-FU-related toxicity.

OBJECTIVES: The objective of this study is to present the current evidence for DPD testing in routine oncological practice.

METHODS: Two systematic literature searches were performed following the PRISMA guidelines. We identified studies examining the possible benefit of DPYD genotyping or DPD phenotyping on the toxicity risk.

FINDINGS: Nine and 12 studies met the criteria for using DPYD genotyping and DPD phenotyping, respectively.

CONCLUSIONS: The evidence supporting either DPYD genotyping or DPD phenotyping as pre-treatment tests to reduce 5-FU toxicity is poor. Further evidence is still needed to fully understand and guide clinicians to dose by DPD activity.

OriginalsprogEngelsk
Sider (fra-til)325-346
Antal sider22
TidsskriftBasic & clinical pharmacology & toxicology
Vol/bind131
Udgave nummer5
Tidlig onlinedato23 aug. 2022
DOI
StatusUdgivet - nov. 2022

Bibliografisk note

© 2022 The Authors. Basic & Clinical Pharmacology & Toxicology published by John Wiley & Sons Ltd on behalf of Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

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