DPYD genotyping and dihydropyrimidine dehydrogenase (DPD) phenotyping in clinical oncology. A clinically focused minireview.
Basic Clin Pharmacol Toxicol
; 131(5): 325-346, 2022 Nov.
Article
in En
| MEDLINE
| ID: mdl-35997509
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.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prodrugs
/
Dihydrouracil Dehydrogenase (NADP)
Type of study:
Guideline
/
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Basic Clin Pharmacol Toxicol
Journal subject:
FARMACOLOGIA
/
TOXICOLOGIA
Year:
2022
Document type:
Article
Affiliation country:
Denmark