Evaluation of clinical implementation of prospective

Fluoropyrimidines are commonly used anti-cancer drugs, but lead to severe toxicity in 10-30% of patients. Prospective screening identifies patients at risk for toxicity and leads to a safer treatment with fluoropyrimidines. This study evaluated the routinely application of prospective screening at t...

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Bibliographic Details
Published in:Pharmacogenomics 2016-05, Vol.17 (7), p.721-729
Main Authors: Lunenburg, Carin ATC, van Staveren, Maurice C, Gelderblom, Hans, Guchelaar, Henk-Jan, Swen, Jesse J
Format: Article
Language:English
Subjects:
5-fluorouracil
capecitabine
dihydropyrimidine dehydrogenase
dose reductions
fluoropyrimidines
implementation
screening
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Summary:Fluoropyrimidines are commonly used anti-cancer drugs, but lead to severe toxicity in 10-30% of patients. Prospective screening identifies patients at risk for toxicity and leads to a safer treatment with fluoropyrimidines. This study evaluated the routinely application of prospective screening at the Leiden University Medical Center. Prospective screening as part of routine patient care was evaluated by retrospectively screening databases and patient files to determine genotype, treatment, dose recommendations and dose adjustments. 86.9% of all patients with a first fluoropyrimidine prescription were screened. Fourteen out of 275 patients (5.1%) carried a variant and received a 25-50% dose reduction recommendation. None of the patients with a variant treated with a reduced dose developed toxicities. Prospective screening can be implemented successfully in a real world clinical setting, is well accepted by physicians and results in low toxicity.
ISSN:1462-2416
1744-8042
DOI:10.2217/pgs-2016-0013