Pharmacogenomic testing before chemotherapy
Testing a patient's inherited genes before certain chemotherapies to spot people who cannot break the drug down and would suffer severe, sometimes fatal, side effects.
Overview
Germline variants alter how patients handle several cancer drugs. DPYD variants reduce dihydropyrimidine dehydrogenase and cause severe toxicity with fluorouracil and capecitabine; UGT1A1*28 raises irinotecan toxicity; TPMT and NUDT15 variants make thiopurines dangerous. Pre-treatment DPYD testing is required or recommended across much of Europe and by the NHS, and dose reduction guided by genotype has been shown to cut severe toxicity without loss of efficacy.
How it works
Genotype defined variants from blood or saliva and adjust starting doses according to consortium guidelines such as those of the Clinical Pharmacogenetics Implementation Consortium.
- Prevents severe and fatal toxicity
- Cheap, once-per-lifetime test
- Guideline-backed dose tables
- Covers only known variants and ancestries unevenly
- Turnaround can delay treatment
- Uptake outside Europe remains patchy
Latest papers
topQuery for this technology: (TITLE:"Pharmacogenomic testing before chemotherapy" OR ABSTRACT:"Pharmacogenomic testing before chemotherapy") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Pharmacogenomic testing before chemotherapy, not a curated reading list.
Similar pages
not linked directly; found by shared links- TreatmentUridine triacetate
Shares Capecitabine, Fluorouracil (5-FU).
- Key paperHurwitz 2004: bevacizumab with chemotherapy for metastatic colorectal cancer, the first anti-angiogenic drug to extend life
Shares Irinotecan (and liposomal irinotecan), Fluorouracil (5-FU).
- TreatmentTegafur, gimeracil and oteracil (S-1)
Shares Capecitabine, Fluorouracil (5-FU).
- TargetThymidylate synthase (TYMS)
Shares Capecitabine, Fluorouracil (5-FU).
- Key paperToGA (Bang 2010): trastuzumab with chemotherapy for HER2-positive advanced gastric cancer
Shares Capecitabine, Fluorouracil (5-FU).
- TermFOLFOX, FOLFIRI, FOLFIRINOX and CAPOX
Shares Irinotecan (and liposomal irinotecan), Fluorouracil (5-FU).
- Key paperConroy 2011: FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer (PRODIGE 4/ACCORD 11)
Shares Irinotecan (and liposomal irinotecan), Fluorouracil (5-FU).
- CancerHepatoblastoma
Shares Irinotecan (and liposomal irinotecan), Fluorouracil (5-FU).