Feasibility of preemptive pharmacogenetic testing in colorectal cancer patients within a community oncology setting

Introduction Pharmacogenetics, in hand with precision medicine in oncology, represents an opportunity to holistically tailor a patient’s treatment regimen using both somatic and germline variants to improve efficacy and decrease toxicity. Colorectal cancer patients represent a population with freque...

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Bibliographic Details
Published in:Journal of oncology pharmacy practice 2022-06, Vol.28 (4), p.842-849
Main Authors: Luczak, Tiana S, Schillo, Paul J, Renier, Colleen M, Waring, Stephen C, Friday, Bret B
Format: Article
Language:English
Subjects:
Chemotherapy
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms - drug therapy
Colorectal Neoplasms - genetics
Feasibility Studies
Humans
Irinotecan
Irinotecan - therapeutic use
Oncology
Patients
Pharmacists
Pharmacogenetics
Pharmacogenomic Testing
Precision medicine
Toxicity
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Summary:Introduction Pharmacogenetics, in hand with precision medicine in oncology, represents an opportunity to holistically tailor a patient’s treatment regimen using both somatic and germline variants to improve efficacy and decrease toxicity. Colorectal cancer patients represent a population with frequent use of fluoropyrimidine and irinotecan and are an ideal opportunity for implementation of preemptive pharmacogenetics as evidence supports pharmacogenetic testing for DPYD and UGT1A1 to reduce fluoropyrimidine and irinotecan toxicities. Methods This was a single arm proof-of-concept study at a large community-based health system. Participants provided samples for pharmacogenetic testing via an external vendor prior to chemotherapy initiation and an oncology pharmacist was responsible for pharmacogenetic interpretation and pharmacogenetic-guided therapeutic recommendation to the treating provider. Results A total of 24 (60%) participants had a UGT1A1 variant. All participants (100%) were DPYD*1/*1. Results were available and interpreted for 29/40 (72.5%) participants prior to scheduled chemotherapy initiation (p value
ISSN:1078-1552
1477-092X
DOI:10.1177/10781552211005529