Routine dihydropyrimidine dehydrogenase testing fo... [Clin Colorectal Cancer. 2010] - PubMed result

Clin Colorectal Cancer. 2010 Oct 1;9(4):224-8.
Routine dihydropyrimidine dehydrogenase testing for anticipating 5-Fluorouracil-related severe toxicities: hype or hope?

Ciccolini J, Gross E, Dahan L, Lacarelle B, Mercier C.

La Timone University Hospital, Marseille, France.
Abstract

5-Fluorouracil (5-FU) is a mainstay for treating colorectal cancer, alone or more frequently as part of combination therapies. However, its efficacy/toxicity balance is often limited by the occurrence of severe toxicities, showing in about 15%-20% of patients. Several clinical reports have shown the deleterious effect of dihydropyrimidine dehydrogenase (DPD) genetic polymorphism, a condition that reduces the liver detoxification step of standard dosages of 5-FU, in patients undergoing fluoropyrimidine-based therapy. Admittedly, DPD deficiency accounts for 50%-75% of the severe and sometimes life-threatening toxicities associated with 5-FU (or oral 5-FU). However, technical consensus on the best way to identify patients with DPD deficiency before administrating 5-FU is far from being achieved. Consequently, no regulatory step has been undertaken yet to recommend DPD testing as part of routine clinical practice for securing the administration of 5-FU. This review covers the limits and achievements of the various strategies proposed so far for determining DPD status in patients scheduled for 5-FU therapy.

PMID: 20920994 [PubMed - in process]
Routine dihydropyrimidine dehydrogenase testing fo... [Clin Colorectal Cancer. 2010] - PubMed result