A Guide for Implementing DPYD Genotyping for Systemic Fluoropyrimidines into Clinical Practice DOI Creative Commons
R COOPERDEHOFF, D. Max Smith, Christina L. Aquilante

et al.

Clinical Pharmacology & Therapeutics, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 31, 2025

The safety of systemic fluoropyrimidines (e.g., 5-fluorouracil, capecitabine) is impacted by germline genetic variants in DPYD, which encodes the dihydropyrimidine dehydrogenase (DPD) enzyme that functions as rate-limiting step catabolism this drug class. Genetic testing to identify those with DPD deficiency can help mitigate risk severe and life-threatening fluoropyrimidine-induced toxicities. Globally, integration DPYD into patient care has varied greatly, ranging from being required standard some countries limited clinical use others. Thus, implementation strategies have evolved differently across health systems countries. primary objective tutorial provide practical considerations best practice recommendations for DPYD-guided fluoropyrimidine dosing. We adapted Exploration, Preparation, Implementation, Sustainment (EPIS) framework cover topics including evidence supporting genotyping guide therapy, regulatory guidance genotyping, key stakeholder engagement, logistics development point-of-care decision support tools, creation sustainable scalable genotype-integrated workflows. This also describes approaches counseling patients about result disclosure, along examples provider educational resources. Together, aim promote safe prescribing therapy decrease

Language: Английский

A Guide for Implementing DPYD Genotyping for Systemic Fluoropyrimidines into Clinical Practice DOI Creative Commons
R COOPERDEHOFF, D. Max Smith, Christina L. Aquilante

et al.

Clinical Pharmacology & Therapeutics, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 31, 2025

The safety of systemic fluoropyrimidines (e.g., 5-fluorouracil, capecitabine) is impacted by germline genetic variants in DPYD, which encodes the dihydropyrimidine dehydrogenase (DPD) enzyme that functions as rate-limiting step catabolism this drug class. Genetic testing to identify those with DPD deficiency can help mitigate risk severe and life-threatening fluoropyrimidine-induced toxicities. Globally, integration DPYD into patient care has varied greatly, ranging from being required standard some countries limited clinical use others. Thus, implementation strategies have evolved differently across health systems countries. primary objective tutorial provide practical considerations best practice recommendations for DPYD-guided fluoropyrimidine dosing. We adapted Exploration, Preparation, Implementation, Sustainment (EPIS) framework cover topics including evidence supporting genotyping guide therapy, regulatory guidance genotyping, key stakeholder engagement, logistics development point-of-care decision support tools, creation sustainable scalable genotype-integrated workflows. This also describes approaches counseling patients about result disclosure, along examples provider educational resources. Together, aim promote safe prescribing therapy decrease

Language: Английский

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