{Reference Type}: Journal Article
{Title}: Dihydropyrimidine Dehydrogenase Testing prior to Treatment with 5-Fluorouracil, Capecitabine, and Tegafur: A Consensus Paper.
{Author}: Wörmann B;Bokemeyer C;Burmeister T;Köhne CH;Schwab M;Arnold D;Blohmer JU;Borner M;Brucker S;Cascorbi I;Decker T;de Wit M;Dietz A;Einsele H;Eisterer W;Folprecht G;Hilbe W;Hoffmann J;Knauf W;Kunzmann V;Largiadèr CR;Lorenzen S;Lüftner D;Moehler M;Nöthen MM;Pox C;Reinacher-Schick A;Scharl A;Schlegelberger B;Seufferlein T;Sinn M;Stroth M;Tamm I;Trümper L;Wilhelm M;Wöll E;Hofheinz RD;
{Journal}: Oncol Res Treat
{Volume}: 43
{Issue}: 11
{Year}: 2020
{Factor}: 2.844
{DOI}: 10.1159/000510258
{Abstract}: <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.