Dépistage du déficit en dihydropyrimidine déshydrogénase (DPD) et sécurisation des chimiothérapies à base de fluoropyrimidines : mise au point et recommandations nationales du GPCO-Unicancer et du RNPGx Article Swipe
Marie‐Anne Loriot
,
Joseph Ciccolini
,
Fabienne Thomas
,
Chantal Barin‐Le Guellec
,
Bernard Royer
,
G. Milano
,
Nicolas Picard
,
Laurent Becquemont
,
Céline Verstuyft
,
Céline Narjoz
,
Antonin Schmitt
,
Christine Bobin‐Dubigeon
,
Alexandre Harlé
,
Angélo Paci
,
Vianney Poinsignon
,
Sylvie Quaranta
,
Alexandre Evrard
,
Benjamin Hennart
,
Franck Broly
,
Xavier Fonrose
,
Claire Lafay‐Chebassier
,
Anne‐Sophie Wozny
,
Fadil Masskouri
,
Jean-Christophe Boyer
,
Marie‐Christine Etienne‐Grimaldi
·
YOU?
·
· 2018
· Open Access
·
· DOI: https://doi.org/10.1016/j.bulcan.2018.02.001
YOU?
·
· 2018
· Open Access
·
· DOI: https://doi.org/10.1016/j.bulcan.2018.02.001
Fluoropyrimidines (FU) are still the most prescribed anticancer drugs for the treatment of solid cancers. However, fluoropyrimidines cause severe toxicities in 10 to 40% of patients and toxic deaths in 0.2 to 0.8% of patients, resulting in a real public health problem. The main origin of FU-related toxicities is a deficiency of dihydropyrimidine dehydrogenase (DPD), the rate-limiting enzyme of 5-FU catabolism. DPD deficiency may be identified through pharmacogenetics testing including phenotyping (direct or indirect measurement of enzyme activity) or genotyping (detection of inactivating polymorphisms on the DPYD gene). Approximately 3 to 15% of patients exhibit a partial deficiency and 0.1 to 0.5% a complete DPD deficiency. Currently, there is no regulatory obligation for DPD deficiency screening in patients scheduled to receive a fluoropyrimidine-based chemotherapy. Based on the levels of evidence from the literature data and considering current French practices, the Group of Clinical Pharmacology in Oncology (GPCO)-UNICANCER and the French Network of Pharmacogenetics (RNPGx) recommend the following: (1) to screen DPD deficiency before initiating any chemotherapy containing 5-FU or capecitabine; (2) to perform DPD phenotyping by measuring plasma uracil (U) concentrations (possibly associated with dihydrouracil/U ratio), and DPYD genotyping (variants *2A, *13, p.D949V, HapB3); (3) to reduce the initial FU dose (first cycle) according to DPD status, if needed, and further, to consider increasing the dose at subsequent cycles according to treatment tolerance. In France, 17 public laboratories currently undertake routine screening of DPD deficiency.
Related Topics
Concepts
DPYD
Dihydropyrimidine dehydrogenase
Medicine
Capecitabine
Internal medicine
Genotyping
Pharmacogenetics
Oncology
Chemotherapy
Fluorouracil
Cancer
Genotype
Gene
Genetics
Colorectal cancer
Biology
Thymidylate synthase
Metadata
- Type
- review
- Language
- fr
- Landing Page
- https://doi.org/10.1016/j.bulcan.2018.02.001
- OA Status
- hybrid
- Cited By
- 104
- References
- 44
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2788695304
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W2788695304Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1016/j.bulcan.2018.02.001Digital Object Identifier
- Title
-
Dépistage du déficit en dihydropyrimidine déshydrogénase (DPD) et sécurisation des chimiothérapies à base de fluoropyrimidines : mise au point et recommandations nationales du GPCO-Unicancer et du RNPGxWork title
- Type
-
reviewOpenAlex work type
- Language
-
frPrimary language
- Publication year
-
2018Year of publication
- Publication date
-
2018-02-24Full publication date if available
- Authors
-
Marie‐Anne Loriot, Joseph Ciccolini, Fabienne Thomas, Chantal Barin‐Le Guellec, Bernard Royer, G. Milano, Nicolas Picard, Laurent Becquemont, Céline Verstuyft, Céline Narjoz, Antonin Schmitt, Christine Bobin‐Dubigeon, Alexandre Harlé, Angélo Paci, Vianney Poinsignon, Sylvie Quaranta, Alexandre Evrard, Benjamin Hennart, Franck Broly, Xavier Fonrose, Claire Lafay‐Chebassier, Anne‐Sophie Wozny, Fadil Masskouri, Jean-Christophe Boyer, Marie‐Christine Etienne‐GrimaldiList of authors in order
- Landing page
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https://doi.org/10.1016/j.bulcan.2018.02.001Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1016/j.bulcan.2018.02.001Direct OA link when available
- Concepts
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DPYD, Dihydropyrimidine dehydrogenase, Medicine, Capecitabine, Internal medicine, Genotyping, Pharmacogenetics, Oncology, Chemotherapy, Fluorouracil, Cancer, Genotype, Gene, Genetics, Colorectal cancer, Biology, Thymidylate synthaseTop concepts (fields/topics) attached by OpenAlex
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104Total citation count in OpenAlex
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2025: 6, 2024: 15, 2023: 13, 2022: 16, 2021: 13Per-year citation counts (last 5 years)
- References (count)
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44Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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