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All You Need to Know About DPYD Genetic Testing for Patients Treated With Fluorouracil and Capecitabine: A Practitioner-Friendly Guide
- Source :
- JCO Oncology Practice, JCO Oncology Practice, 2020, 16 (12), pp.793-798. ⟨10.1200/OP.20.00553⟩
- Publication Year :
- 2020
- Publisher :
- HAL CCSD, 2020.
-
Abstract
- International audience; Fluoropyrimidines (fluorouracil, capecitabine, and other analogs) are highly used anticancer drugs worldwide. However, patients with cancer treated with these drugs might experience severe, life-threatening toxicity because of germline genetic variation in the DPYD gene. This is a genetic predisposition with an established mechanistic basis that links genetic variation in the DPYD gene to an increase in systemic drug exposure, resulting in an increased risk of toxicity. Pharmacology guidelines provide recommendations on avoiding treatment with fluoropyrimidines or reducing their dose in patients carrying DPYD genetic variants conferring an increased risk of toxicity. However, oncology societies in the United States do not recommend systematic testing. Instead, on April 30, 2020, the European Society for Medical Oncology issued a document recommending genetic testing. In this scenario of contradicting information, practicing oncologists struggle with reaching an informed decision on whether genetic testing should be applied before treatment. This is mostly due to uncertainty about the clinical relevance of genetic testing from the perspective of a practicing oncologist. To reach an informed decision, practicing oncologists need access to concise information on the genetic variants to be tested and a practitioner-friendly interpretation of the test results. We believe this information is currently lacking. To our knowledge, for the first time, we provide a single guide for health care professionals to make an evidence-based decision about DPYD testing for patients with cancer. This article provides the essential knowledge base for oncologists to have an informed discussion with their patients about the genetic testing for DPYD. This document assists practitioners in quickly evaluating whether, when, where, and how to order a DPYD genetic test.
- Subjects :
- medicine.medical_specialty
[SDV]Life Sciences [q-bio]
MEDLINE
01 natural sciences
Capecitabine
03 medical and health sciences
0302 clinical medicine
Genetic variation
Health care
medicine
Genetic predisposition
Clinical significance
Intensive care medicine
Genetic testing
medicine.diagnostic_test
010405 organic chemistry
Oncology (nursing)
business.industry
Health Policy
3. Good health
0104 chemical sciences
Oncology
030220 oncology & carcinogenesis
DPYD
business
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 26881527
- Database :
- OpenAIRE
- Journal :
- JCO Oncology Practice, JCO Oncology Practice, 2020, 16 (12), pp.793-798. ⟨10.1200/OP.20.00553⟩
- Accession number :
- edsair.doi.dedup.....65e243429480fa2ea71839b3517922d6