Genotype-guided fluoropyrimidine dosing: ready for implementation
Menée auprès de 1 103 patients adultes atteints d'un cancer et devant commencer un traitement anticancéreux à base de fluoropyrimidine, cette étude multicentrique évalue la possibilité, dans la pratique clinique de routine, d'effectuer le génotypage du gène codant pour la dihydropyrimidine déshydrogénase afin d'adapter la dose de fluoropyrimidine à administrer et limiter ainsi sa toxicité
More than 20 years have passed since dihydropyrimidine dehydrogenase (DPD; encoded by the gene DPYD) deficiency was first described as a pharmacogenetic syndrome, which puts patients with reduced activity of this key catabolic enzyme at risk of toxicity from fluoropyrimidine-based chemotherapy. More recently, understanding of the effect of DPYD variants on the risk of fluoropyrimidine-related toxicity has improved immensely. For four DPYD variants known to confer reduced DPD activity, a recent meta-analysis confirmed their association with severe fluoropyrimidine-related toxicity. For these same variants, genotype-based dosing recommendations are available. In The Lancet Oncology, Linda Henricks and colleagues report results that represent another important milestone towards clinical implementation of DPYD genotyping.
The Lancet Oncology , commentaire, 2017