Consensus of experts from the Spanish Pharmacogenetics and Pharmacogenomics Society and the Spanish Society of Medical Oncology for the genotyping of DPYD in cancer patients who are candidates for treatment with fluoropyrimidines

5-Fluorouracil (5-FU) and oral fluoropyrimidines, such as capecitabine, are widely used in the treatment of cancer, especially gastrointestinal tumors and breast cancer, but their administration can produce serious and even lethal toxicity. This toxicity is often related to the partial or complete d...

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Autores: García-Alfonso, Pilar|||0000-0002-4373-9978, Saiz-Rodríguez, M.|||0000-0002-1660-3135, Mondéjar, R., Salazar, Juliana|||0000-0002-3581-4499, Paez, David|||0000-0002-5596-6588, Borobia, Alberto M.|||0000-0002-8584-3263, Safont, M. J., García-García, Irene|||0000-0002-2228-6754, Colomer, Ramon|||0000-0002-6393-3444, García-González, Xandra|||0000-0002-6269-7953, Herrero Cervera, María José, López-Fernández, L. A., Abad-Santos, Francisco|||0000-0002-6519-8885
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:258969
Acceso en línea:https://ddd.uab.cat/record/258969
https://dx.doi.org/urn:doi:10.1007/s12094-021-02708-4
Access Level:acceso abierto
Palabra clave:5-fluorouracil
Capecitabine
Dihydropyrimidine dehydrogenase
Genotypes
Pharmacogenetics
Toxicity
Descripción
Sumario:5-Fluorouracil (5-FU) and oral fluoropyrimidines, such as capecitabine, are widely used in the treatment of cancer, especially gastrointestinal tumors and breast cancer, but their administration can produce serious and even lethal toxicity. This toxicity is often related to the partial or complete deficiency of the dihydropyrimidine dehydrogenase (DPD) enzyme, which causes a reduction in clearance and a longer half-life of 5-FU. It is advisable to determine if a DPD deficiency exists before administering these drugs by genotyping DPYD gene polymorphisms. The objective of this consensus of experts, in which representatives from the Spanish Pharmacogenetics and Pharmacogenomics Society and the Spanish Society of Medical Oncology participated, is to establish clear recommendations for the implementation of genotype and/or phenotype testing for DPD deficiency in patients who are candidates to receive fluoropyrimidines. The genotyping of DPYD previous to treatment classifies individuals as normal, intermediate, or poor metabolizers. Normal metabolizers do not require changes in the initial dose, intermediate metabolizers should start treatment with fluoropyrimidines at doses reduced to 50%, and poor metabolizers are contraindicated for fluoropyrimidines.