1. UPFRONT DPD DEFICIENCY DETECTION TO SECURE 5-FU ADMINISTRATION: PART 2- APPLICATION TO HEAD-AND-NECK CANCER PATIENTS
- Author
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Sébastien Salas, Claire Fournel, Carmello Blanquicett, Charlotte Dupuis, Joseph Ciccolini, Florence Duffaud, Manon Launay, Bruno Lacarelle, and Nicolas Fakhry
- Subjects
Cancer Research ,medicine.medical_specialty ,business.industry ,Head and neck cancer ,Functional testing ,Cancer ,medicine.disease ,Article ,Oncology ,Internal medicine ,Toxicity ,medicine ,Chi-square test ,Dihydropyrimidine dehydrogenase ,Observational study ,Dosing ,General Pharmacology, Toxicology and Pharmaceutics ,business - Abstract
Background Upfront screening for dihydropyrimidine dehydrogenase (DPD) deficiency in patients scheduled for 5-FU should help reduce the risk of toxicities by preventive adaptive dosing. Our group has developed a simple functional testing categorizing patients upon their DPD status, i.e. extensive metabolizer (EM) or poor metabolizer (PM) patients, using UH2/U ratio measurement in plasma as a surrogate for DPD activity. 5-FU dosing can then be tailored according to DPD deficiency status. Objectives We present here an observational study of this strategy implemented in routine clinical practice when treating head-and-neck cancer patients. Results A total of 218 evaluable adult patients were treated with a 5-FU-regimen, with DPD-based adaptive dosing. Among them, 20 (9%) were identified as PM and received subsequently a 20-50% reduced dosing of 5-FU as compared with EM patients (2102 ±254 mg VS. 2577 ±353mg, p
- Published
- 2018