Fluoropyrimidine-induced toxicity and DPD deficiency.. A case report of early onset, lethal capecitabine-induced toxicity and mini review of the literature. Uridine triacetate: Efficacy and safety as an antidote. Is it accessible outside USA?

Fluoropyrimidine-based regimens are among the most commonly used chemotherapy combinations for the treatment of solid tumors. Several genetic polymorphisms that are implicated with fluoropyrimidine anabolism and catabolism have been associated with the development of life-threatening toxicities. Uridine triacetate is an FDA-approved antidote for 5-fluorouracil or capecitabine overdose and early-onset, life-threatening toxicity within 96 h of last chemotherapy dose. To date, it is not accessible for Greek patients as per the current summary of product characteristic's time restrictions. We report and discuss the course and outcome of capecitabine toxicity in a 66-year-old female colorectal cancer patient with heterozygous dihydropyrimidine dehydrogenase deficiency. This paper highlights the difficulty in timely access of this lifesaving medication for Greek and possibly other European patients.

Immune-related dermatologic toxicities: to make a long story short.

Immune checkpoint inhibitors have demonstrated durable responses in some patient groups and gained regulatory approval for various cancer indications since 2011. Autoimmune and autoinflammatory adverse events, secondary to the use of such agents are known as "immune-related adverse events" (irAEs) and their incidence, severity and tolerability may vary among the classes of the checkpoint inhibitors. This short review provides an update and summarises the clinical manifestations and management of cutaneous irAEs induced by checkpoint inhibitors that are currently in use.