Clinical implementation of pre-treatment DPYD genotyping in capecitabine-treated metastatic breast cancer patients

Stavraka, C; Pouptsis, A; Okonta, L; DeSouza, K; Charlton, P; Kapiris, M; Marinaki, A; Karapanagiotou, E; Papadatos-Pastos, D; Mansi, J

Women's Health Collection

Journal article

Clinical implementation of pre-treatment DPYD genotyping in capecitabine-treated metastatic breast cancer patients

Abstract:: Purpose Metastatic breast cancer (mBC) patients with DPYD genetic variants linked to loss of dihydropyrimidine dehydrogenase (DPD) activity are at risk of severe capecitabine-associated toxicities. However, prospective DPYD genotyping has not yet been implemented in routine clinical practice. Following a previous internal review in which two patients underwent lengthy hospitalisations whilst receiving capecitabine, and were subsequently found to be DPD deficient, we initiated routine DPYD genotyping prior to starting capecitabine. This study evaluates the clinical application of routine DPYD screening at a large cancer centre in London. Methods We reviewed medical records for consecutive patients with mBC who underwent DPYD genotyping before commencing capecitabine between December 2014 and December 2017. Patients were tested for four DPYD variants associated with reduced DPD activity. Results Sixty-six patients underwent DPYD testing. Five (8.4%) patients were found to carry DPYD genetic polymorphisms associated with reduced DPD activity; of these, two received dose-reduced capecitabine. Of the 61 patients with DPYD wild-type, 14 (23%) experienced grade 3 toxicities which involved palmar–plantar erythrodysesthesia (65%), and gastrointestinal toxicities (35%); no patient was hospitalised due to toxicity. Conclusions Prospective DPYD genotyping can be successfully implemented in routine clinical practice and can reduce the risk of severe fluoropyrimidine toxicities

Publication status:: Published

Peer review status:: Peer reviewed

Actions

Email

Email this record

Send the bibliographic details of this record to your email address.

Your Email
Please enter the email address that the record information will be sent to.

-
Your message (optional)
Please add any additional information to be included within the email.
Share
Cite

Cite this record

APA Style

Stavraka, C., Pouptsis, A., Okonta, L., DeSouza, K., Charlton, P., Kapiris, M., Marinaki, A., Karapanagiotou, E., Papadatos-Pastos, D., & Mansi, J. (2019). Clinical implementation of pre-treatment DPYD genotyping in capecitabine-treated metastatic breast cancer patients. Breast Cancer Research and Treatment, 175(2), 511–517.

MLA Style

Stavraka, C, et al. “Clinical Implementation of Pre-Treatment DPYD Genotyping in Capecitabine-Treated Metastatic Breast Cancer Patients.” Breast Cancer Research and Treatment, vol. 175, no. 2, 2019, pp. 511–17.

Chicago Style

Stavraka, C, A Pouptsis, L Okonta, et al. 2019. “Clinical Implementation of Pre-Treatment DPYD Genotyping in Capecitabine-Treated Metastatic Breast Cancer Patients.” Breast Cancer Research and Treatment 175 (2): 511–17.
Print