Evaluation of clinical implementation of prospective DPYD genotyping in 5-fluorouracil- or capecitabine-treated patients
Evaluation of clinical implementation of prospective DPYD genotyping in 5-fluorouracil- or capecitabine-treated patients
复制标题
DOI：
10.2217/pgs-2016-0013
复制
发表时间：
2016-05-01
期刊：
影响因子：
2.1
通讯作者：
Swen, Jesse J.
中科院分区：
文献类型：
--
作者：
Lunenburg, Carin A. T. C.;van Staveren, Maurice C.;Swen, Jesse J.
目的：氟嘧啶类药物是常用的抗癌药物，但有10-30%的患者出现严重毒性反应。前瞻性的DPYD筛查确定有毒性风险的患者，并导致使用氟嘧啶类药物进行更安全的治疗。这项研究评估了莱顿大学医学中心前瞻性DPYD筛查的常规应用。方法：通过回顾筛查数据库和患者档案对作为常规患者护理一部分的前瞻性DPYD筛查进行评估，以确定基因型、治疗、剂量推荐和剂量调整。结果：86.9%的第一次使用氟嘧啶处方的患者得到了筛查。275名患者中有14名(5.1%)携带DPYD变异，并接受了25%-50%的剂量减少建议。接受减量治疗的DPYD变异患者中没有一人出现毒性反应。结论：前瞻性DPYD筛查可以在真实的临床环境中成功实施，被医生很好地接受，结果是低毒的。
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.