1. [Dihydropyrimidine dehydrogenase deficiency screening for management of patients receiving a fluoropyrimidine: Results of two national practice surveys addressed to clinicians and biologists].
- Author
-
Loriot MA, Masskouri F, Carni P, Le Malicot K, Seitz JF, Michel P, Legoux JL, Bouché O, André T, Faroux R, Delaloge S, Malka D, Guigay J, Thariat J, Thomas F, Barin-Le-Guellec C, Ciccolini J, Boyer JC, and Étienne-Grimaldi MC
- Subjects
- Antimetabolites, Antineoplastic therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Biology, Biomedical Research, Breast Neoplasms drug therapy, Capecitabine therapeutic use, Digestive System Neoplasms drug therapy, Dihydropyrimidine Dehydrogenase Deficiency genetics, Female, Fluorouracil therapeutic use, France, Genotype, Humans, Oncologists, Otorhinolaryngologic Neoplasms drug therapy, Pharmacovigilance, Practice Guidelines as Topic, Pyrimidines adverse effects, Pyrimidines therapeutic use, Reimbursement Mechanisms, Antimetabolites, Antineoplastic adverse effects, Capecitabine adverse effects, Dihydropyrimidine Dehydrogenase Deficiency diagnosis, Dihydropyrimidine Dehydrogenase Deficiency drug therapy, Fluorouracil adverse effects, Health Care Surveys statistics & numerical data
- Abstract
Dihydropyrimidine dehydrogenase (DPD) deficiency is the main cause of early severe toxicities induced by fluoropyrimidines (FP). The French Group of Clinical Oncopharmacology (GPCO)-Unicancer and the French Pharmacogenetics Network (RNPGx) initiated two surveys, one addressed to oncologists, the other to biologists, in order to evaluate routine practices regarding DPD deficiency screening at national level, as well as compliance, motivations and obstacles for implementation of these tests. These anonymized online surveys were performed with the logistic assistance of the Francophone Federation of Digestive Oncology (FFCD) and the support of numerous medical and biological societies. The surveys were conducted in 2016-2017 before the creation of the French INCa/HAS expert panel, which contributed to the drafting of rules and recommendations for DPD deficiency screening published in December 2018. In all, 554 questionnaires from clinicians were analyzed (23% participation) and 35 from biologists. The main arguments raised by clinicians for justifying the limited practice of DPD deficiency screening were: the lack of recommendations from medical societies or Health Authorities, delays in obtaining results, and the lack of adequate reimbursement by the health insurance system. The goal of these surveys was to provide the French Health Authorities with an overview on nationwide DPD-deficiency screening practices and thus help to design recommendations for the standardization and improvement of the management and safety of cancer patients receiving FP-based chemotherapy., (Copyright © 2019 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF