Resumen de Severe toxicity to capecitabine for possible enzymatic deficiency

Manuel Prieto Castello, Eva Hernández Lorente, Corina Escoin Pérez, M. Teresa Taberner Bonastre

• Dihydropyrimidine dehydrogenase (DPD) is the limiting enzyme involved in the degradation of 5-FU and, therefore, there is a close relationship between DPD levels and the effect of capecitabine. The deficiency of this enzyme can cause severe toxicity even leading to death. We describe a case of grade IV mucocutaneous toxicity due to a possible DPD deficit, and analyzed the causality using the modified Karch-Lasagna algorithm. Although the screening of the DPD deficit would allow to individualize the doses in these patients, these determinations are not implemented in the daily practice of most hospitals