Do you regularly perform pharmacogenomic testing for patients prior to starting chemotherapy?

At my center, we routinely perform DPYD genotyping prior to chemotherapy with 5-FU or capecitabine. This is a practice that is supported by very strong evidence from multiple prospective studies (see especially Henricks et al., PMID 30348537). The most important benefit of screening for DPD deficien...

Because fluoropyrimidines are a pillar of therapy in colorectal cancer and it is not known with certainty that given dihydropyrimidine dehydrogenase (DPYD) variants are associated with high risk and/or that dose adjustments do not impact treatment efficacy, universal pretreatment DPYD genotyping is ...

I do not test for either DYPD mutation or UGTA1A variants. The presence of UGTA1A variant may result in slightly higher neutropenia, but this is less than interpatient variability and can be addressed by appropriate dose reduction.

Regarding DYPD, this is an important issue due to potential fatal tox...

I am routinely offering DPYD testing prior to starting patients on fluoropyrimidines but we do not have an institutional policy. While I agree with the argument that more data are needed on the dose adjustments in patients with DPYD variants, I feel more comfortable knowing the genotype and prefer t...

Both answers above from Dr. @Dr. First Last and Dr @Dr. First Last represents the sides of the spectrum of this debate in practice in the United States. Practically, I can say I have been trying to send the Mayo Clinic Panel (https://www.mayocliniclabs.com/test-catalog/overview/610063#Specimen) for ...