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

Pilar García Alfonso; M. Saiz Rodríguez; Rebeca Mondéjar Solís; Juliana Salazar Blanco; David Páez López-Bravo; Alberto Borobia Pérez; María José Safont; I. García García; Ramón Colomer Bosch; X. García González; M. J. Herrero; Luis Andrés López Fernández; Francisco Abad Santos

Ayuda

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

P. García-Alfonso ^[1] ; M. Saiz-Rodríguez ^[2] ; R. Mondéjar ^[3] ; J. Salazar ^[8] ; D. Páez ^[4] ; A. M. Borobia ^[5] ; M. J. Safont ^[6] ; I. García-García ^[5] ; R. Colomer ^[9] ; X. García-González ^[1] ; M. J. Herrero ^[7] ; L. A. López-Fernández ^[1] ; F. Abad-Santos ^[3]
1. [1] Hospital General Universitario Gregorio Marañón
  
  Hospital General Universitario Gregorio Marañón
  
  Madrid, España
2. [2] Complejo Asistencial Universitario de Burgos
  
  Complejo Asistencial Universitario de Burgos
  
  Burgos, España
3. [3] Hospital Universitario de la Princesa
  
  Hospital Universitario de la Princesa
  
  Madrid, España
4. [4] Hospital de la Santa Creu i Sant Pau
  
  Hospital de la Santa Creu i Sant Pau
  
  Barcelona, España
5. [5] Hospital Universitario La Paz
  
  Hospital Universitario La Paz
  
  Madrid, España
6. [6] Hospital General Universitario de Valencia
  
  Hospital General Universitario de Valencia
  
  Valencia, España
7. [7] Universitat de València
  
  Universitat de València
  
  Valencia, España
8. [8] Research Institute of Hospital de la Santa Creu I Sant Pau, Sociedad Española de Farmacogenética y Farmacogenómica (SEFF), Barcelona, Spain
9. [9] Medical Oncology Service, Hospital Universitario de La Princesa y Cátedra de Medicina Personalizada de Precisión de la Universidad Autónoma de Madrid (UAM), Sociedad Española de Oncología Médica (SEOM), Madrid, Spain
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Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 24, Nº. 3 (Marzo), 2022, págs. 483-494
Idioma: inglés
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Resumen
- 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.