Carin Atc Lunenburg1, Maurice C van Staveren2,3, Hans Gelderblom1, Henk-Jan Guchelaar3, Jesse J Swen3. 1. Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands. 2. Department of Pharmacy, Treant Healthgroup, The Netherlands. 3. Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands.
Abstract
AIM: Fluoropyrimidines are commonly used anti-cancer drugs, but lead to severe toxicity in 10-30% of patients. Prospective DPYD screening identifies patients at risk for toxicity and leads to a safer treatment with fluoropyrimidines. This study evaluated the routinely application of prospective DPYD screening at the Leiden University Medical Center. METHODS: Prospective DPYD screening as part of routine patient care was evaluated by retrospectively screening databases and patient files to determine genotype, treatment, dose recommendations and dose adjustments. RESULTS: 86.9% of all patients with a first fluoropyrimidine prescription were screened. Fourteen out of 275 patients (5.1%) carried a DPYD variant and received a 25-50% dose reduction recommendation. None of the patients with a DPYD variant treated with a reduced dose developed toxicities. CONCLUSION: Prospective DPYD screening can be implemented successfully in a real world clinical setting, is well accepted by physicians and results in low toxicity.
AIM: Fluoropyrimidines are commonly used anti-cancer drugs, but lead to severe toxicity in 10-30% of patients. Prospective DPYD screening identifies patients at risk for toxicity and leads to a safer treatment with fluoropyrimidines. This study evaluated the routinely application of prospective DPYD screening at the Leiden University Medical Center. METHODS: Prospective DPYD screening as part of routine patient care was evaluated by retrospectively screening databases and patient files to determine genotype, treatment, dose recommendations and dose adjustments. RESULTS: 86.9% of all patients with a first fluoropyrimidine prescription were screened. Fourteen out of 275 patients (5.1%) carried a DPYD variant and received a 25-50% dose reduction recommendation. None of the patients with a DPYD variant treated with a reduced dose developed toxicities. CONCLUSION: Prospective DPYD screening can be implemented successfully in a real world clinical setting, is well accepted by physicians and results in low toxicity.
Authors: Elena De Mattia; Rossana Roncato; Chiara Dalle Fratte; Fabrizio Ecca; Giuseppe Toffoli; Erika Cecchin Journal: Cancer Drug Resist Date: 2019-03-19
Authors: Ursula Amstutz; Linda M Henricks; Steven M Offer; Julia Barbarino; Jan H M Schellens; Jesse J Swen; Teri E Klein; Howard L McLeod; Kelly E Caudle; Robert B Diasio; Matthias Schwab Journal: Clin Pharmacol Ther Date: 2017-11-20 Impact factor: 6.875
Authors: Rebecca Wellmann; Brittany A Borden; Keith Danahey; Rita Nanda; Blase N Polite; Walter M Stadler; Mark J Ratain; Peter H O'Donnell Journal: Cancer Date: 2018-05-09 Impact factor: 6.860
Authors: Charlotte I S Barker; Gabriella Groeneweg; Anke H Maitland-van der Zee; Michael J Rieder; Daniel B Hawcutt; Tim J Hubbard; Jesse J Swen; Bruce C Carleton Journal: Br J Clin Pharmacol Date: 2022-02-07 Impact factor: 3.716
Authors: Jonathan E Knikman; Hans Gelderblom; Jos H Beijnen; Annemieke Cats; Henk-Jan Guchelaar; Linda M Henricks Journal: Clin Pharmacol Ther Date: 2020-11-12 Impact factor: 6.875