%0 Journal Article
%T Dihydropyrimidine Dehydrogenase Testing prior to Treatment with 5-Fluorouracil, Capecitabine, and Tegafur: A Consensus Paper.
%A Wörmann B
%A Bokemeyer C
%A Burmeister T
%A Köhne CH
%A Schwab M
%A Arnold D
%A Blohmer JU
%A Borner M
%A Brucker S
%A Cascorbi I
%A Decker T
%A de Wit M
%A Dietz A
%A Einsele H
%A Eisterer W
%A Folprecht G
%A Hilbe W
%A Hoffmann J
%A Knauf W
%A Kunzmann V
%A Largiadèr CR
%A Lorenzen S
%A Lüftner D
%A Moehler M
%A Nöthen MM
%A Pox C
%A Reinacher-Schick A
%A Scharl A
%A Schlegelberger B
%A Seufferlein T
%A Sinn M
%A Stroth M
%A Tamm I
%A Trümper L
%A Wilhelm M
%A Wöll E
%A Hofheinz RD
%J Oncol Res Treat
%V 43
%N 11
%D 2020
%M 33099551
%F 2.844
%R 10.1159/000510258
%X <B>BACKGROUND: </B>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%.<BR><B>CONCLUSIONS: </B>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.