Ethnic Diversity of DPD Activity and the DPYD Gene: Review of the Literature

Pharmacogenomic screening can identify patients with gene variants that predispose them to the development of severe toxicity from fluoropyrimidine (FP) chemotherapy. Deficiency of the critical metabolic enzyme dihydropyrimidine dehydrogenase (DPD) leads to excessive toxicity on exposure to fluoropy...

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Bibliographic Details
Published in:Pharmacogenomics and personalized medicine 2021-01, Vol.14, p.1603-1617
Main Authors: White, Cassandra, Scott, Rodney J, Paul, Christine, Ziolkowski, Andrew, Mossman, David, Ackland, Stephen
Format: Article
Language:English
Subjects:
Cancer
Cancer therapies
Chemotherapy
Dehydrogenases
dihydropyrimidine dehydrogenase
dpyd gene
Enzymes
Genes
Genotypes
Investigations
Literature reviews
Metabolism
Metabolites
Multiculturalism
Multiculturalism & pluralism
non-caucasian
Patients
Pharmacogenetics
Pharmacogenomics
Review
Toxicity
White people
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Summary:Pharmacogenomic screening can identify patients with gene variants that predispose them to the development of severe toxicity from fluoropyrimidine (FP) chemotherapy. Deficiency of the critical metabolic enzyme dihydropyrimidine dehydrogenase (DPD) leads to excessive toxicity on exposure to fluoropyrimidine chemotherapy. This can result in hospitalisation, intensive care admissions and even death. Upfront screening of the gene that encodes for DPD ( ) has recently been implemented in regions throughout Europe and the United Kingdom. Current screening evaluates variants that are well described within Caucasian patient populations and provides genotyped-guided dose adjustment recommendations based upon the presence of these variants. This article reviews the differences in gene variants within non-Caucasian populations compared to Caucasian populations, with regard to the implications for clinical tolerance of fluoropyrimidine chemotherapies and genotype guided dose adjustment guidelines.
ISSN:1178-7066
1178-7066
DOI:10.2147/PGPM.S337147