Dihydropyrimidine Dehydrogenase Testing prior to Treatment with 5-Fluorouracil, Capecitabine, and Tegafur: A Consensus Paper

Woermann B, Bokemeyer C, Burmeister T, Koehne CH, Schwab M, Arnold D, Blohmer JU, Borner M, Brucker S, Cascorbi I, Decker T, De Wit M, Dietz A, Einsele H, Eisterer W, Folprecht G, Hilbe W, Hoffmann J, Knauf W, Kunzmann V, Largiader CR, Lorenzen S, Luftner D, Moehler M, Nothen MM, Pox C, Reinacher-Schick A, Scharl A, Schlegelberger B, Seufferlein T, Sinn M, Stroth M, Tamm I, Trumper L, Wilhelm M, Woell E, Hofheinz RD (2020)

Publication Type: Journal article, Review article

Publication year: 2020

Journal

Book Volume: 43

Pages Range: 628-636

Journal Issue: 11

DOI: 10.1159/000510258

Abstract

Background: 5-Fluorouracil (FU) is one of the most commonly used cytostatic drugs in the systemic treatment of cancer. Treatment with FU may cause severe or life-threatening side effects and the treatment-related mortality rate is 0.2-1.0%. Summary: Among other risk factors associated with increased toxicity, a genetic deficiency in dihydropyrimidine dehydrogenase (DPD), an enzyme responsible for the metabolism of FU, is well known. This is due to variants in the DPD gene (DPYD). Up to 9% of European patients carry a DPD gene variant that decreases enzyme activity, and DPD is completely lacking in approximately 0.5% of patients. Here we describe the clinical and genetic background and summarize recommendations for the genetic testing and tailoring of treatment with 5-FU derivatives. The statement was developed as a consensus statement organized by the German Society for Hematology and Medical Oncology in cooperation with 13 medical associations from Austria, Germany, and Switzerland. Key Messages: (i) Patients should be tested for the 4 most common genetic DPYD variants before treatment with drugs containing FU. (ii) Testing forms the basis for a differentiated, risk-adapted algorithm with recommendations for treatment with FU-containing drugs. (iii) Testing may optionally be supplemented by therapeutic drug monitoring.

Involved external institutions

Universitätsmedizin der Johannes Gutenberg-Universität Mainz Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE) Universitätsklinikum Leipzig Germany (DE) Universität Ulm Germany (DE) Asklepios Klinik Altona Germany (DE) Universität Mannheim Germany (DE) Krankenhaus St. Vinzenz Betriebs GmbH Austria (AT) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie (DGHO) e.V. Germany (DE) Klinikum Oldenburg Germany (DE) Julius-Maximilians-Universität Würzburg Germany (DE) Vivantes - Netzwerk für Gesundheit GmbH Germany (DE) Wilhelminenspital Austria (AT) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) Klinikum rechts der Isar Germany (DE) Ruhr-Universität Bochum (RUB) Germany (DE) Klinikum Klagenfurt am Wörthersee Austria (AT) Kliniken Nordoberpfalz Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) Robert-Bosch-Krankenhaus Germany (DE) Christian-Albrechts-Universität zu Kiel Germany (DE) Rheinische Friedrich-Wilhelms-Universität Bonn Germany (DE) Oncocare Switzerland (CH) Georg-August-Universität Göttingen Germany (DE) Paracelsus Medizinische Privatuniversität Austria (AT) Universitätsklinikum Heidelberg Germany (DE) Krankenhaus St. Joseph-Stift GmbH Germany (DE) Eberhard Karls Universität Tübingen Germany (DE) Inselspital, Universitätsspital Bern Switzerland (CH)

How to cite

APA:

Woermann, B., Bokemeyer, C., Burmeister, T., Koehne, C.-H., Schwab, M., Arnold, D.,... Hofheinz, R.-D. (2020). Dihydropyrimidine Dehydrogenase Testing prior to Treatment with 5-Fluorouracil, Capecitabine, and Tegafur: A Consensus Paper. Oncology Research and Treatment, 43(11), 628-636. https://doi.org/10.1159/000510258

MLA:

Woermann, Bernhard, et al. "Dihydropyrimidine Dehydrogenase Testing prior to Treatment with 5-Fluorouracil, Capecitabine, and Tegafur: A Consensus Paper." Oncology Research and Treatment 43.11 (2020): 628-636.

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