Implementing DPYD genotyping to predict chemotherapy toxicity in Australia: a feasibility study
Article Swipe
Cassandra White
,
Christine Paul
,
Esther Liet
,
Dilshan Kalpage
,
David Mossman
,
Andrew Ziolkowski
,
Stephen P. Ackland
,
Rodney J. Scott
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1111/imj.16576
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1111/imj.16576
Background Implementing pharmacogenomic‐guided management in cancer patients equitably and effectively in a large population presents challenges. DPYD genotyping determines clinically significant variants of patients at increased risk of developing grade3–5 fluoropyrimidine (FP) toxicity. FP chemotherapies are prescribed for ~16,000 Australians with a 10%–40% grade3–4 toxicity incidence and 1% mortality. Variant carriers can have FP dosing adjusted to improve treatment tolerance without compromising anticancer effect. This strategy has not been formally adopted within Australia, despite widespread international standardisation. Aim This pilot study determined genotyping turnaround‐times (TAT) for 4 DPYD variants (c.1905+1G>A, c.1679T>G, c.2846A>T and c.1236G>A/Haplotype B3) in Australian patients. Secondary objectives were identification of FP toxicities of DPYD variant carriers, and analysis of healthcare stakeholder perspectives, including enablers/barriers to implementation. Methods Genotyping was determined by Real‐Time Polymerase Chain Reaction. Qualitative data were determined through semi‐structured questionnaire. Results 104 patients recruited over 24 months had a mean TAT of 7.2 days, 5.2 business days (range 1–30). Grade3–4 toxicity occurred in 9/16 DPYD variant carriers, including 2 ICU admissions and 1 death. Themes from 30 questionnaire respondents suggest that clinical environment and resources were fundamental barriers, and motivation to improve patient care was the predominant enabler of change. Conclusion DPYD genotyping is feasible for improving precision‐oncology for patients requiring FP chemotherapies. A TAT of 7 days is acceptable by both stakeholder respondents and national oncology clinician groups. This pilot study, although small, informs a large national project evaluating prospective DPYD genotyping and its impact on FP tolerability, patient safety and cost‐effectiveness in Australia.
Related Topics
Concepts
DPYD
Medicine
Genotyping
Pharmacogenomics
Oncology
Internal medicine
Dosing
Toxicity
Common Terminology Criteria for Adverse Events
Pharmacogenetics
Pharmacology
Genotype
Genetics
Biology
Gene
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1111/imj.16576
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/imj.16576
- OA Status
- bronze
- References
- 34
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4409364609
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4409364609Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1111/imj.16576Digital Object Identifier
- Title
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Implementing
DPYD genotyping to predict chemotherapy toxicity in Australia: a feasibility studyWork title - Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2025Year of publication
- Publication date
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2025-04-11Full publication date if available
- Authors
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Cassandra White, Christine Paul, Esther Liet, Dilshan Kalpage, David Mossman, Andrew Ziolkowski, Stephen P. Ackland, Rodney J. ScottList of authors in order
- Landing page
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https://doi.org/10.1111/imj.16576Publisher landing page
- PDF URL
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/imj.16576Direct link to full text PDF
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YesWhether a free full text is available
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bronzeOpen access status per OpenAlex
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/imj.16576Direct OA link when available
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DPYD, Medicine, Genotyping, Pharmacogenomics, Oncology, Internal medicine, Dosing, Toxicity, Common Terminology Criteria for Adverse Events, Pharmacogenetics, Pharmacology, Genotype, Genetics, Biology, GeneTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
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34Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.pharmacogenomic‐guided | 3 |
| cited_by_percentile_year | |
| countries_distinct_count | 1 |
| institutions_distinct_count | 8 |
| citation_normalized_percentile.value | 0.16699358 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |