Cost-effectiveness of screening for DPYD polymorphisms to prevent neutropenia in cancer patients treated with fluoropyrimidines

To compare the cost of screening for three mutations in the dihydropyrimidine dehydrogenase gene and the costs of treating severe fluoropyrimidine-induced neutropenia. The polymorphisms rs3918290 (DPYD*2A), rs67376798 (DPYD 2846A>T) and rs55886062 (1679T>G, DPYD*13) were genotyped using real-t...

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Bibliographic Details
Published in:Pharmacogenomics 2016-06, Vol.17 (9), p.979-984
Main Authors: Cortejoso, Lucía, García-González, Xandra, García, María I, García-Alfonso, Pilar, Sanjurjo, María, López-Fernández, Luis A
Format: Article
Language:English
Subjects:
Antimetabolites, Antineoplastic - adverse effects
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Cancer therapies
Colorectal cancer
Colorectal Neoplasms - genetics
Consortia
Cost analysis
Cost-Benefit Analysis
Dehydrogenases
Deoxyribonucleic acid
Dihydrouracil Dehydrogenase (NADP) - genetics
DNA
DNA probes
Drug dosages
Drug stores
Estimates
Female
Fluorouracil - adverse effects
Genetic Testing - economics
Genotype
Genotype & phenotype
Genotyping
Humans
Lysis
Male
Metastasis
Mutation
Neoplasms - drug therapy
Neoplasms - genetics
Neutropenia
Neutropenia - economics
Neutropenia - genetics
Neutropenia - prevention & control
Patients
Polymerase Chain Reaction
Polymorphism, Genetic - genetics
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Summary:To compare the cost of screening for three mutations in the dihydropyrimidine dehydrogenase gene and the costs of treating severe fluoropyrimidine-induced neutropenia. The polymorphisms rs3918290 (DPYD*2A), rs67376798 (DPYD 2846A>T) and rs55886062 (1679T>G, DPYD*13) were genotyped using real-time PCR, TaqMan probes and a rapid cell lysis to provide PCR-ready DNA. We found that genotyping 1000 patients in our center cost €6400 and that the mean cost of treating severe neutropenia was €3044. Therefore, if severe fluoropyrimidine-induced neutropenia is reduced by genotyping the three DPYD variations in at least 2.21 cases per 1000 treated patients, then DPYD genotyping will prove cost effective. We demonstrated that real-time DPYD genotyping using TaqMan probes is cost effective in all fluoropyrimidine-based treatments.
ISSN:1462-2416
1744-8042
DOI:10.2217/pgs-2016-0006